Investigator Gazetteer Registration

Only one Investigator per registration

Only US Investigators.

No fees.

Terms and Privacy Policy.

Registration Form

    Submission Type – New Registrations and Updates will be posted within one working week.

    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.

    Investigator's Email (required)

    Investigator’s Prefix (required)
    Dr.

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

    Investigator’s Medical Speciality - Select One (required)

    Investigator's Bio - Truncated at 150 words (put NA if no BIO)

    Investigator’s Bio (required)

    Number of Trials Conducted by Investigator Annually - Average (required)

    Investigator’s Trial Interest – List maximum seven (7) conditions / diseases (separator, comma sign)

    Condition / Disease (required)

    Preferred Study Type(s) - Multiple Selections Possible (required)
    Industry-SponsoredNIH etcInvestigator-Initiated

    Preferred Study Phase(s) - Multiple Selections Possible (required)
    Phase I.Phase II.Phase III.Phase IV.Observational Studies

    Preferred Study Product(s) - Multiple Selections Possible (required)
    DrugsVaccinesMedical DevicesCell TherapiesNatural ProductsMedical DiagnosticsRadiology / ImagingMedical ProceduresSurgery

    Study Site / Medical Clinic Information

    Site Name (required)

    Site Location - Address (required)

    Site Location - City (required)

    Site Location - State US First (required)

    Site Location - Zip (required)

    Site Location - Country (required)

    The phone number will be listed on the Clinical Investigator Gazetteer website. You can avoid this by not giving the phone number below - give NA.

    Site Contact – Phone (required)

    The site's website will be listed on the Clinical Investigator Gazetteer website. You can avoid this by not giving the website below - give NA.

    Site Website (required)

    NOTE: Check email. Must be correct. Some general information will be sent to this email.

    Site Email - Contact (required)

    Study Site Description - Truncated at 150 words (put NA if no description)

    Site Study Services (required))

    Study Site / Medical Clinic Characteristics

    Clinic Type (required)

    Site Type (required)

    IRB Type (required)

    Declaration by Investigator

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