Risk Management Division - Clinical Trials Database

Notification of Clinical Trial

	Ethics approval
	Ethics approval from own institution OR
	Ethics approval from other institution
	Other institution's name

	Investigators
	Principal investigator(s)
	Relationship to University
	School/Department involved

	Trial Details
	Trial Title and Brief Description
	Sponsor
	Indemnity provided by sponsor?
	List indemnity exclusions if any
	Granting body for non-sponsored trials
	Target participant numbers for the period 1/11/08 to 31/10/09
	Target participant numbers for the full trial period
	Number of sites
	Invasive nature of trial e.g. eg taking blood samples, tissue sampling, surgical procedures, ingestion of any substance, application of creams, ointments etc.
	Starting date
	Estimated Period of trial (estimated period of ethics project)
	Specify if CTN/CTX (incl phase)
	Name of drug(s)
	Dosage of drug(s)
	Claims from previous phases known to you