Get Office Of Clinical Trials Research Study Application Form

Filling out the OFFICE OF CLINICAL TRIALS Research Study Application Form is a crucial step in the process of submitting a research project. This guide provides a clear, step-by-step approach to completing the form accurately and efficiently, ensuring timely review and consideration of your research.

Follow the steps to effectively complete your research study application form.

1. Click the ‘Get Form’ button to access the application and open it for editing.
2. Fill in the principal investigator’s information including name, phone number, and email. Ensure all details are accurate as this contact will be essential for follow-up communications.
3. Provide the primary contact's information if different from the principal investigator, including name, phone number, and email.
4. Specify the department or division associated with the research study by entering the relevant information.
5. Enter the title of your research proposal clearly and concisely to reflect the focus of your study.
6. Indicate all sites where you will conduct the study by checking the appropriate boxes.
7. Answer whether the study requires participants to be inpatients at any point. Select 'Yes' or 'No'.
8. Confirm if all study activities are limited to the outpatient setting by selecting 'Yes' or 'No'.
9. If activities will occur at any WMC clinic, specify the clinic and the related study activities.
10. Indicate if WMC ancillary services are required for the study and check which specific services apply.
11. List all tests or procedures that will be funded by the study sponsor that are not billable to third-party payers.
12. Provide information on any drugs that the sponsor will supply at no cost.
13. Detail any specific ancillary services needed, procedures involved, and frequencies as applicable.
14. Answer the coverage analysis question regarding the trial's qualification under the National Coverage Determination.
15. If applicable, provide details regarding hospitalization needs for study participants.
16. State any special procedures involved in the study and identify who will perform them.
17. If the study involves an investigational device, confirm and provide details about the device.
18. Submit the form along with any required documents including the protocol, budget, agreements, etc.
19. Once all fields are complete, review the form for accuracy, save your changes, and download or print a copy for your records.

Complete your OFFICE OF CLINICAL TRIALS Research Study Application Form online today for a thorough and timely review.