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Investigator Sponsored Trial Form

If you prefer to fill out this information in a Microsoft Word Document, please download the template below and upload it. There is no need to fill out all the fields except for the contact information if you are uploading the Word document. Also, if you have a full protocol developed, please upload that as well. The submission button is at the end of this webpage.

Click here to download the Investigator Sponsored Trial Form
Contact Information
First Name
Last Name
E-Mail Address
Phone  (ex. 123-456-7890)
Other relevant individuals for contact
Additional Request Info - Option 1.) Upload Request Form Document
Download and complete the Investigator Sponsored Trial Form in word format linked to above, then upload it here.
Additional Request Info - Option 2.) Online Request Form
Fill out the form online. All questions are required if selecting this option.
Click here to select option 2 and enter additional info
Funding of your Investigator Sponsored Trial will be reviewed. Review times may vary, however typical review times will be around 2-3 weeks. You may check the status by e-mailing us at IST@americanregent.com.