Investigator Registration

Only one Investigator per registration

Only US Investigators can register at present

There will not be any fee – at present or in the future - for Investigators registering with the Investigator Gazetteer.

Registration Form

    Submission Type (required)

    Investigator Information

    Investigator’s First Name (required)

    Investigator’s Last Name (required)

    NOTE: Check email. Must be correct. All communications such as trial proposals will be sent to this email. The email address will NOT be posted publicly.

    Investigator's Email (required)

    Investigator’s Academic Degrees - Multiple Selections Possible (required)
    MDPhDMBADDSPharmDMasterBachelor

    Investigator’s Medical Speciality - Select One (required)

    Number Trials Conducted by Investigator Annually - Average (required)

    Study Site / Medical Clinic Information

    Site Name (required)

    Site Location - Address (required)

    Site Location - City (required)

    Site Location - State (required)

    Site Location - Zip (required)

    Site Location - Country (required)

    The phone number will NOT be posted publicly. Put NA if not available.

    Site Contact – Phone (required)

    The site's website will NOT be posted publicly. Put NA if not available

    Site Website (required)

    NOTE: Check email. Must be correct. Some general information will be sent to this email. The email address will NOT be posted publicly.

    Site Email - Contact (required)

    Clinic Type (required)

    Site Type (required)

    IRB Type (required)

    Declaration by Investigator

    I understand the terms of this submission and accept the terms (required)

    Registration Terms 

    Please review the general Terms and Privacy Policy for this Website.