Worldwide Clinical Trials

Clinical investigators make significant contributions to improving healthcare every day. Through research, new medicines get to patients sooner.

Experienced in clinical research? Be sure to register your site in our database in order to be considered for study opportunities.

Join our network of qualified investigators today by filling out the form below:

Fields with an asterisk (* ) are required.

General Information

Site Name: *
Mailing Address: *
Suite:
City: *
State: *
Zip: *
Main Phone: *
Fax Number: *
Principal Investigator First Name: *
Principal Investigator Last Name: *
Degree: *
MD Licensure: *
MD Exp. Date: *
MD State of Issuance: *
DEA Licensure: *
DEA Exp. Date: *
DEA State of Issuance: *
Phone Number: *
Mobile Number: *
Fax Number: *
Email Address: *
Site Contact/Coordinator Name: *
Setting of the Research study site: *		Hospital Clinic Private Practice Other
Do you have adequate Study Physician coverage for instances where a protocol specified visit may fall on a weekend day?: *		Yes No
Is your practice privately owned?: *		Yes No
Is your practice exclusively research oriented?: *		Yes No
Is your practice affiliated with an academic institution?: *		Yes No
Is your practice part of an SMO?: *		Yes No


Because you have checked SMO or academic institution, please provide contact information below:
SMO / Academic Institution Name: *
Mailing Address: *
Suite:
City: *
State: *
Zip: *
Main Phone: *
Fax Number: *
Web Address: *

Has your site ever been audited by the FDA?: *		Yes No
Has your site ever been audited by an IRB?: *		Yes No
Have any of your PIs or Sub-Investigators ever had their Medical License revoked or suspended in any state?: *		Yes No

How long has the Principal Investigator been conducting clinical research (Number of Years)? *
How many clinical trials has the PI been involved with by Phase?		* Phase I: * Phase II: * Phase III: * Phase IV:

Do you have Clinical Trial experience in the following areas?

Please check the appropriate boxe(s):


Cardiovascular

Acute Coronary Syndrome:
Ischemic Heart Disease:
Acute Peripheral Arterial Occlusion:
Peripheral Artery Disease:
Atrial Fibrillation:

Central Nervous System

Psychiatry
ADHD:
Bipolar Disorder:
Generalized Anxiety Disorder:
Major Depressive Disorder:
Obsessive-Compulsive:
Panic Disorder:
Schizophrenia Social Phobia:

Analgesia
Arthritic Pain:
Chronic Pain:
Low Back Pain:
Migraine:
Neuropathic Pain:
Post-operative Pain:

Neurology
Alzheimer’s Disease:
Mild Cognitive Impairment:
Parkinson’s Disease:
Stroke:

Other Expertise

Chronic Inflammatory Diseases
Rheumatology:
Dermatology:
Gastroenterology:

Metabolic / Endocinology

Oncology