Investigator-initiated Trials

Application

The following requirements must be met:

Applicants eligible to apply are physicians or researchers
Applicants must be qualified by training and experience to perform the proposed research
Applications are to be submitted via application form including information for all fields marked as mandatory
Add current CV (mandatory)
Add Protocol or Protocol Synopsis (non-mandatory)

Please note:

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Study team

* Principal Investigator Full Name

Contact details primary investigator (lead study center)

* Center

Street

Postcode

* City

* Country

* E-Mail

Phone

Additional study centers

* Are addtional study centers planned?

Yes

Protocol Synopis

* Study short title

* Rationale of study

* Objective

* Hypothesis

* Primary Outcome

* Secondary Outcomes

Study design

Prospective

Retrospective

Controlled

Randomized

Observational

Single-arm (single cohort)

Non-randomized

Other

* Subject Population

* Methods

* Project timeline

Other relevant information

Support requested

Device support

Monetary support

Device and monetary support

Other (e.g. data sharing request)

Investigator Qualifications and experience

Diabetes Technology

Information on ongoing studies

Specify the most relevant ongoing studies you are running (as PI or co-investigator)

Study 1:

* Type

* Title

* Industry Partner

Study 2:

Type

Title

Industry Partner

Study 3:

Type

Title

Industry Partner

Supporting Documentation

* CV (GCP and/or ISO 14155:2020 training is expected)

Durchsuchen Dateien zum Hochladen

Protocol synopsis, if available (does not replace this form, all fields must be completed)

Durchsuchen Dateien zum Hochladen

Protocol (if available)

Durchsuchen Dateien zum Hochladen

Note:

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* Mandatory Fields