Cost Analysis Request Form (WT00)
Completing this form will help Wayturn estimate an accurate cost per enrollment for your clinical research study.
Name
Email:
*
What best describes your research study?
Study with in-person visits
Virtual study without in-person visits
(hidden) Location information
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Upload Research Study Documents
Please upload files, or provide links to, as many of the following documents as possible: Full Eligibility Criteria, Patient Consent Form, Information Brochure, and current Promotional Materials.
Upload Multiple Study Documents
Browse Files
Browse or drag and drop files using the button above.
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[Optional] Additional comments
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Study Details
Provide details for recruitment dates, number of enrollments, compensation, phone screening and clinic screening if applicable.
Enrollment Overview:
Rows
Number of People
Total Enrollment Target
Current Enrollments
When is your Recruitment Period?
Are Participants compensated or reimbursed for participating in this study?
Yes
No
What is the compensation in USD?
Per visit, total or an average if not applicable.
Can the compensation be shown on adverts?
Yes
No
Maybe
Other
Is Phone Screening part of this study?
Yes
No
Other
What percentage of people do you expect to pass Phone Screening? Please provide the source for this statistic if possible.
If unsure, please leave blank.
Is Clinic Screening part of this study?
Yes
No
Other
What percentage of people do you expect to pass Clinic Screening? Please provide the source for this statistic if possible.
If unsure, please leave blank
Submit
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