Skip to content
Investigator and Allergy Expert Consultant Registry Questionnaire
*
Your contact details
(Required.)
Name
*
Institution Name
*
Address
*
Address 2
City/Town
*
State/Province
*
ZIP/Postal Code
*
Country
*
Email Address
*
Main contact number
*
Your expertise (tick all applicable)
(Required.)
Allergist
ENT
Pulmonologist
Dermatologist
Internist
Paediatrician
General Physician
Other (please specify)
*
In which role would you like to support us? (tick all applicable)
(Required.)
(Principal) Investigator
Allergy Expert Consultant
Other (please specify)
*
In which of these areas have you had experience with ATL (tick all applicable)?
(Required.)
Clinical trials and other studies
Products
Events/Meetings/Congresses
None
Other
*
In how many allergy immunotherapy trials or product development programs have you supported/acted as a principal investigator in the last 5 years?
(Required.)
0
1-2
3-5
6+
*
When did you last attend a Good Clinical Practice (GCP) training course?
(Required.)
Never attended
1-2 years ago
3-5 years ago
6+ years ago
*
Subject Population available at your site (tick all applicable)
(Required.)
Children (<12 years)
Adolescents (>12 years)
Adults
*
What study role(s) do you currently have in your team (tick all applicable)?
(Required.)
Sub-Investigator
Study Coordinator
None
Other (please specify)
*
Please specify the number of staff in your team
(Required.)
Sub-Investigator
Study Coordinator
None
Other (please specify)
*
Do you operate a pollen trap or have access to pollen counts for your region?
(Required.)
Yes
No
For any further questions or if you wish to get in touch with the study team, please contact us at
clinicaltrials@allergytherapeutics.com
1 star
2 stars
Current Progress,
0 of 11 answered
