Site Interest Form

Are you interested in joining Clinique Research’s site database?

We maintain and update a global database of sites that assist us in supporting studies in a range of therapeutic areas. We want to expand this database by adding research-ready sites and investigators who want to be included for future Clinique Studies.

Filling out this form is the first step in Clinique Research and your organization developing a relationship and being considered as a possible site. We will call you after we receive your completed form to set up a formal meeting with the Clinique Research team to further evaluate your site for inclusion in the database.

Thank you for taking the time to complete this survey; if you have any questions or need assistance, please contact info@cliniqueresearchng.com.

First Name Last Name Title Phone Number Your email Source Organization Company Organization Type Street City State/Province Zip/Postal Code Country Trial Experience Please provide brief description of your research site clinical experience. This will allow us to cater opportunities to your experience and capability. Phase IPhase IIPhase IIIPhase IV Phase Comments Patient Accommodation Vaccine Trial Experience

Clinique Research Limited > Site Interest Form