Clinical Trial Feasibility Questionnaire Form
Please complete this form to help us assess your site's suitability for participation in an upcoming clinical study. All responses will be reviewed for feasibility screening purposes only.
Site Name
*
Principal Investigator Full Name
*
First Name
Last Name
Contact Email Address
*
example@example.com
Site Location (City, State/Region, Country)
*
Does your site have prior experience conducting clinical trials?
*
Yes
No
Estimated number of eligible patients available for the study
Does your site have access to necessary facilities and equipment for this study?
*
Yes
No
Partial / Some equipment only
Please describe your site's experience with regulatory submissions and IRB/EC processes.
Is your site interested in participating in this specific clinical study?
*
Yes
No
Maybe / Need more information
Additional Comments or Relevant Information
Submit Feasibility Questionnaire
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