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Clinical Trial Status Report Form (Singapore) Mobile App

This mobile application takes place of a paper status report. It includes basic information about the trial and then it goes into detail about the trial. It is a two page mobile application with the second page being in spreadsheet layout, for the final form.

  • Lendlease
  • The Cooperative
  • PG&E
  • Red Bull
  • Mirvac

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Take a peek inside the Clinical Trial Status Report Form (Singapore) Mobile App

Included Features

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Included Fields

Customize to add, remove, or edit any of the fields below.

  • Ico textbox

    HSA Clinical Trial PRISM Application No:

  • Ico textbox

    Local Sponsor:

  • Ico textbox

    Protocol No:

  • Ico textbox

    Protocol Date:

  • Ico textbox

    Title of Clinical Trial:

  • Ico dropdown

    Centre

  • Ico textbox

    Name of Principal Investigator

  • Ico textbox

    Designation

  • Ico textbox

    Name of Clinical Trial Centre

  • Ico textbox

    Planned No.

  • Ico textbox

    3.1 Status of Clinical Trial* * Status of Clinical Trial: Not started yet, Ongoing, Suspended, Te...

  • Ico textbox

    3.2 If clinical trial has started, please provide the date of initiation (DD/MM/YYYY)

  • Ico textbox

    3.3 If clinical trial has not started, please provide reason

  • Ico textbox

    3.4 If clinical trial has completed, please provide the date of completion (DD/MM/YYYY)

  • Ico textbox

    3.5 If clinical trial is suspended, please provide the date of completion (DD/MM/YYYY) Please pro...

  • Ico textbox

    3.6 If clinical trial has been terminated / prematurely closed, please provide date of terminatio...

  • Ico textbox

    3.7 If site has been prematurely closed, please provide date of site closure (DD/MM/YYYY) Please ...

  • Ico textbox

    3.8 No of subjects screened

  • Ico textbox

    3.9 No of screened failures

  • Ico textbox

    3.10 No of subjects pending screening outcome

  • Ico textbox

    No of subjects enrolled (i.

  • Ico textbox

    3.12 No of subjects withdrawn or prematurely terminated

  • Ico textbox

    3.13 Please provide reasons for subjects withdrawal or premature termiantion

  • Ico textbox

    3.14 No of subjects ongoing

  • Ico textbox

    3.15 No of subjects completed

  • Ico textbox

    3.16 No of SAEs experiences by local subjects

  • Ico textbox

    Has there been an internal audit conducted for this clinical trial site?

  • Ico textbox

    3.18 Please provide any supplementary information to this status report, if necessary:

  • ...and More!

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