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Clinical Trial Studies
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Investigator Registration

Thank you for your interest in registering as an investigator with INC Research. This online registration process will take approximately 15 minutes to complete. Once you have entered data in all required fields, your registration into our Investigator Database will be complete. For questions regarding registration, contact feasibility@incresearch.com.

To simplify and speed up the registration process, we suggest you have available all contact information you will need to register. This includes addresses, phone and fax numbers, email addresses for all hospitals, clinics or academic institutions where you work.

Before you begin, please take a moment to read and understand our privacy policy. Again, thank you for your interest in INC Research.

Fields with an asterisk(*) are optional. All information must be accurately reported and updated, as necessary, to appropriately select Investigators for the clinical trials.

Investigator Information
First Name:
Middle Name:*
Last Name:
Degree:
Mailing Address:
City:
Country:
State/Territory:
Postal Code:
Primary Phone:
Fax:
Alternate Phone:*
Email:
 
Primary Contact for Clinical Trials
First Name:
Last Name:
Organization/Dept Name:
Address:
City:
Country:
State/Territory:
Postal Code:
Phone:
Fax:
Email:
 
Research Setting
Please indicate the trial phase(s) in which you have experience:
Can you utilize a Central Review Board (Institutional Review Board/Ethics Committee)?
 
What is the age of the patients involved in your research?
 
Facility Details
Facility Name:
Facility Type:
Address:
City:
Country:
State/Territory:
Postal Code:
Phone:
Fax:
Email:
 
Therapeutic Specialties
Investigator Specialty:

Please indicate your interests in future clinical trials (provide specific diseases, indications, tumor types):
 
Investigator Data Protection

Our Commitment to Privacy

INC Research®, Inc. and each of its subsidiaries (collectively "INC Research") are committed to respecting the privacy of clinical trial research investigators. We endeavor to limit the use of the information that you provide to us for the purposes of responsible business practices, in accordance with applicable laws. Our internal procedures apply to all processing of data, on-line and off-line, manual and electronic, and all entities holding your personal data presented to us for legitimate purposes. INC Research requires adherence to privacy principles as it relates to disclosed personal information, as follows:

  • the information be processed lawfully and fairly;
  • the use of information be limited to the purpose first identified and to other compatible uses;
  • the information be used in conjunction with consent of the individual investigator;
  • the information be subject to reasonable security precautions to protect it;
  • the information collected be relevant for the purposes of its intended use;
  • the information be accurate, and to the extent reasonable, complete and current;
  • the information be protected by adequate mechanisms to resolve complaints;
  • the information be kept no longer than necessary for its intended purpose;
  • advanced notice to be given of the intended use and the recipients of the information;
  • prior to use for another purpose, individual be given opportunity to consent;
  • Authorized agents working on behalf of INC Research and relevant clinical trial sponsors be encouraged to execute confidentiality agreements in connection with handling confidential information containing personal data in accordance with applicable laws.

All inquiries related to your personal information in the possession of INC Research can be submitted electronically to INC Research’s designated Privacy Officer at dataprivacyofficer@incresearch.com. In the alternative, the Privacy Officer may be notified at:
            Data Privacy Officer, INC Research, Inc.
            4700 Falls of Neuse Road, Suite #400
            Raleigh, North Carolina 27609-6200

Personal Information

INC Research may retain the following information concerning a research investigator in its global database:

  • investigator name and contact information;
  • associated legal entity name, address, entity type, practice specialty, patient population;
  • historical information in connection with prior relationship with INC Research;
  • affiliation with another legal entity, such as site management organization and associated information;
  • as appropriate, other information relevant to the conduction of human clinical trials.

Consent

By making the selection below, I agree that the following information relevant to clinical trial research is permitted to be retained by INC Research for the purposes of adding my information to its global investigator database. If I agree, I understand and permit my personal information to be used for the purposes of conducting clinical trial research and recognize that my information may be considered for studies conducted in the US and on an international basis. Accordingly, my information disclosed may be disseminated for clinical trial purposes trans-border in accordance with applicable laws. I understand that the recipients of my information may include the following: Sponsors of clinical trials for the purpose of selecting investigators; Sponsors of a clinical trial for the purposes of considering the feasibility of conducting the trial; applicable regulatory agencies in the US and elsewhere; and INC Research applicable subsidiaries and affiliates for the purposes of evaluating sites to conduct clinical trials.

I understand that I have a right to reasonably access personal information that INC Research may hold about me, so that I am able to review for accuracy, correct, amend, or delete that information. I understand that I have the right to withdraw consent for INC Research to retain my personal information.
I hereby permit and consent to INC Research’s use and processing of my personal information for the purposes of clinical trial research; please contact me for future clinical trial opportunities as a result of this registration.

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