Clinical study name (required - for internal reference)
Unique number of forms (required - each form can hold about 10-20 fields)
Duration (required - specify months)
Patients (required - total screened patients for the study)
Sites (required - total number of sites for the study)
Additional services Hosting (specify if you want to host your eCrf in our certified cloud) Yes
Randomization Yes
Custom import data (used for lab, images, pdf or other import service: please specify in additional information) Yes
Additional information
Personal information Your name (required)
Your email (required)
Company