Registration Form
To be able to conduct clinical trials.
Organization
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ASCAP, BMI, SESAC...
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Investigator's Name
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Please select any of the following Specialties for which you or your Organization has experience and/or an interest in conducting clinical trials
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Cardiology
Cytology/Histology/Embryology
Dentistry
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Endocrinology
Epidemiology
Gastroenterology
General Practice
Genetics
Gerontology/Geriatrics
Gynecology/Obstetrics
Hemat/Transfusion Med
Hepatology
Immunology/Rheumatology
Inf. Disease/Infectiology
Intensive Care
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Oncology
Ophtalmology
Orthodontics
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Physical Med/Rehab
Physiotherapy
Preventive Medicine
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Public Health
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Radiology
Radiotherapy/Nuclear Medicine
Social Medicine
Sport Medicine
Surg-Plastic and Reconst.
Surgery-Abdominal
Surgery-Angiology/Vascular
Surgery-Cardiovascular
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How many years have you worked in research?
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List of Previous Research Trial Conducted
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Person Completing Form
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