Protocol Registration System (Logo) Federal Sponsors' Logos: DHHS, NIH, FDA

  Administrator Contact Request
OMB NO: 0910-0459
EXPIRATION DATE: 01/31/2011
Burden Statement
Each entity submitting data to ClinicalTrials.gov must adhere to the following terms and conditions, which are intended to ensure the accuracy, currency and validity of the data.
  1. Only data on trials approved by the appropriate regulatory authority may be submitted to ClinicalTrials.gov.
  2. Notice of recruiting status changes must be done immediately, and all submitted data must be reviewed, verified, and updated every six months.
  3. The submitting organization is responsible for the completeness and accuracy of the data submitted to ClinicalTrials.gov.
  4. Trial data must be submitted in English.
  5. Multiple groups within a single entity (e.g., company, university, government agency) must share a single PRS organization account.
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If your organization is already registered with ClinicalTrials.gov, provide the following information to request contact with your organization's PRS administrator.
 
Organization: Enter the name exactly as it appears in the PRS Organization Account List.

Requestor Information
Name:
Department or Group:
Phone:
Email:
 

Questions about this form and the Protocol Registration System (PRS) may be sent to register@ClinicalTrials.gov.