Get Uc San Diego Health Intake Form For Industry Sponsors

Completing the UC San Diego Health Intake Form For Industry Sponsors online is a straightforward process designed to gather essential information from users regarding their clinical trials. Follow this guide to ensure all required sections are filled out accurately and effectively.

Follow the steps to complete the form seamlessly.

1. Press the ‘Get Form’ button to access the form and open it in your preferred editor.
2. In the 'Person completing this form' section, specify whether you are an industry representative or a CRO representative by selecting the appropriate option.
3. Provide your contact information, including your name, company, title, phone number, and email address in the designated fields.
4. In the 'Product type' section, check all relevant options that pertain to your product, including stem cell, gene therapy, or other listed types.
5. Indicate the trial phase you are in by checking all applicable phases such as Phase I, Phase II, or any other options listed.
6. Complete the 'Current FDA status' section by selecting the status that applies to your submission or trial.
7. If applicable, enter your ClinicalTrials.gov identifier or NCT number in the provided space.
8. Input the anticipated trial start date in the specified mm/dd/yy format.
9. In the 'Funding status' section, indicate if you have secured funding and provide the source if applicable. If funding has not yet been secured, select that option and provide your funding plan details.
10. In the 'Services being requested' section, check all services you require from UC San Diego, such as identifying a principal investigator or establishing a non-disclosure agreement.
11. Provide the disease indication in the designated space.
12. Optionally, enter the project title in the provided field.
13. Once you have completed all sections, review your entries for accuracy. You can then save changes, download, print, or share the form as needed.

Complete your forms online today for efficient document management.