Sponsor Information The sponsoring organization is the entity with primary responsibility for initiating and conducting the study to be registered.
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Type of Organization
* : |
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Country
* : |
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Organization Name
* : |
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Organization Address
* : |
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Organization Abbreviations and Acronyms
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Parent Organizations
, if any: |
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Official Representative
* : |
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Phone
* : |
Please enter a valid phone number, including area code.
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Email
* | |
Organization URL
(optional): |
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Funding Organization
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Administrator Information: The
administrator is the person authorized by the sponsor to update the
information in the Protocol Registration System (PRS) and will serve as
the point of contact for the ClinicalTrials.gov staff. |
Administrator Name
* : |
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Affiliation
(if not the sponsor): |
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Administrator Phone
* : |
Please enter a valid phone number, including area code.
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Administrator Email
* : |
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Regulatory Information: The regulatory authority may be a national or international health authority,
an institutional review board or an ethics committee.
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Regulatory Authority
* : |
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Regulatory Authority Address
* : |
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To the best of my knowledge, the above
information is true and correct. Questions about this form and the
Protocol Registration System (PRS) may be sent to register@ClinicalTrials.gov.
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