Register to be a clinical trial investigator for TKL

TKL invites physicians to apply to serve as investigators for clinical trials in a variety of therapeutic areas. As a TKL investigator, your clinical expertise may assist in the development of safe, effective products and therapies.

Please fill out the form below to register as an investigator with TKL. Registering enables us to enter information about you and your facility into our database. We can then contact you to participate in clinical studies relevant to your areas of expertise. Registration does not obligate you in any way.

Receipt of your registration will be confirmed by email.

A. Site/Office/Practice Name:
Address:
City: State/Province: Zip:
Phone: Ext: Fax:
Site E-Mail Address:
Website Address:

B. Contact Person

Contact Name:
Title:
Contact E-Mail Address:
Contact Phone: Ext: Contact Fax:

C. Site Information

Please select one of the following options that best describes your site setting:

Hospital	Clinic	University
Private Practice only	Private Practice/Clinical Research Site	Independent Clinical Research Site
SMO/TMO	Urgent Care Facility	Other
Children's Hospital

If you checked SMO/TMO, what is the name of this organization?
Contact Name:
Contact Phone:
Contact E-Mail Address:
How many years has the Principal Investigator been conducting clinical research trials?
How many full-time study coordinators are employed by your site?
What day(s) of the week is your site closed?

D. IRB Information Please select one of the following options as applicable to your site:
Local IRB Central IRB Site is able to use both Local and Central IRB
If your site utilizes LOCAL IRB, how frequently does the IRB meet? Weekly Bi-Monthly Monthly
What is the average turnaround time for your IRB to approve studies? weeks

E. Contractual Information
Do you have a department that reviews contracts? Yes No
What is the average turnaround time for contract review?
Can contracts be reviewed prior to IRB submission/approval? Yes No
Other contractual issues TKL needs to be aware of?

F. Investigators(Please complete one section for each PI at your site)