Trial and drug must be registered with Pharmacy. Campus where protocol will be conducted Civic General Riverside Heart Institute The Rehabilitation Center Protocol Title Protocol Number OHREB Number Principal Investigator Fax Study Coordinator Fax: Sponsor Clinical Trial Monitor Fax Anticipated Start Date Total Number of patients Billing Information Entity Campus (if available) Acronym (if any) OHREB Approval Date Telephone E-Mail Telephone E-Mail Telephone E-Mail Length.
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How to fill out the Ohri Extranet online
Completing the Ohri Extranet form is essential for initiating clinical trials services. This guide provides step-by-step instructions to help users navigate the online form efficiently.
Follow the steps to successfully fill out the Ohri Extranet form.
- Click ‘Get Form’ button to access the Ohri Extranet form and open it in your preferred online editing tool.
- Select the campus where the protocol will be conducted by checking the appropriate box: Civic, General, Riverside, Heart Institute, or The Rehabilitation Center.
- Enter the protocol title in the designated field.
- Provide the protocol number to identify the study.
- Fill in the OHREB number required for regulatory approval.
- Specify the principal investigator's name, including their contact fax number.
- Input the study coordinator's name along with their fax number.
- Include the name of the sponsor overseeing the study.
- Provide the name of the clinical trial monitor and their fax number.
- Fill out the anticipated start date for the clinical trial.
- Indicate the total number of patients expected to participate in the trial.
- Complete the billing information by selecting the entity campus, if applicable.
- If there is an acronym for the trial, enter it in the designated field.
- Fill in the OHREB approval date to confirm compliance with regulation.
- Provide your telephone and e-mail information, repeating the process for any additional contacts required.
- Specify the length of the study in months in the provided field.
- Enter the relevant cost centre and account numbers for billing purposes.
- Ensure the investigator or designee's name is printed clearly, followed by the date.
- Obtain the required signature from the investigator or designee.
- Once completed, save your changes, and consider downloading or printing the form for your records. You may also share it electronically as necessary.
Complete your Ohri Extranet form online today to facilitate your clinical trial services.
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