Investigator Registration Form
First Name
*
:
Last Name:
MCI Reg No.:
Organisation:
Address:
Country
*
:
State
*
:
City
*
:
Zip/Postal Code:
Phone Work:
Mobile No.
*
:
Fax:
Email
*
:
Is the site attached with local/independent IRB/EC
*
:
YES
NO
IRB meeting frequency:
Twice in a month
Every month
Once in a two month
Once in a three month
Other
Comments:
Copyright © 2010 Aurum Clinical Research. All rights reserved