Our main purpose is to help the Pharmaceutical Companies and Contract Research Organizations to find the right Physician Investigator to assure the rapid and accurate completion of the clinical trial.
Valuable Investigators Database Concept Research
Pre-Study Assessmen Questoinnaire
Country: ROMANIA City: .......................... Participant name: .......................... Participant speciality: .......................... Participant title: .......................... Practice: □ Private □Public □Hospital □Specialized Clinic □SMO □Other……….
Institution name: .......................... Institution address: .......................... Phone number: .......................... Fax number: .......................... E-mail: ..........................
Recruitment
1.Please if possible, please estimate the number of patients that your hospital serves? ………………………………………………………………………………….....................
2.What would be your main source of subjects for this trial? ( ) Physician referrals from the community ( ) Your own patient database ( ) Other (Please specify)
3.Would you be willing to utilize advertising/recruitment materials for this trial? ( ) Yes ( ) No
4.If yes, please check those you'd be willing to use (if EC/IRB approved): ( ) Patient leaflet providing education about clinical trials in general ( ) Patient leaflet - trial specific ( ) Appointment reminder cards ( ) Template letters that may use to send to community physicians to seek referrals ( ) Internet postings such as CenterWatch ( ) Speaking engagements ( ) Other (Please specify)
5.Does your institution post open clinical trials to a publicly accessible website? ( ) Yes ( ) No
6.If yes, please provide name of the website: ……………………………………………………
7.What types of recruitment materials have you used in the past (e.g. internet postings, patient flyers, referral letters)? ………………………………………………………………………………………….................................................
8. Do you have performed in the last year an ICH GCP training ? ( ) Yes ( ) No
Facilities 9.Please describe below wich of the following facilities do you have access to? ( ) Computer Tomography (CT) ( ) RMI ( ) Echo doppler ( ) Echo cardiography ( ) EKG ( ) Weight measurement ( ) X-Ray ( ) ................................ |
Dear participant thank you very much for giving us a more deep insight into the acceptance and practicability of the planned clinical study and your potential for participating. Please don’t hesitate to give us any further comments to the planned project.
All your answers will be summarized and reported anonymously on a per country basis.
PERSONAL DATA OR PRIVACY PROTECTION
Please be advised that VID Concept Research must track and electronically maintain certain information associated with Investigators and sites in order to perform
expected duties on behalf of its Sponsors, such as Investigator selection and ongoing project management. In compliance with applicable personal
data protection or privacy principles, VID Concept Research is hereby informing you that personal information you provide to us may be maintained in this way and
may be transferred to the Sponsor, or other regulatory bodies. The information to be maintained includes, but is not limited to the following:
• Investigator name and contact information
• Other relevant information to allow selection for appropriate projects in the future