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.
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: ..........................
Trial Experience
1.Have you participated as an investigator (PI or sub-I) in any previous clinical trials?
( ) Yes
( ) No
2.If yes, please indicate the number of trials:
…………………………………………………
3.If yes, please provide indication :
………………………………………
4.Please also, provide if possible the companies name(CROs or Sponsors) with you work it:
………………………………………………………………………………………………......
5.Are you, as a PI, participating in any current trials?
( ) Yes
( ) No
6.If yes, please provide the number:
……………………………………………
7.If yes, please provide the indication:
……………………………………………