Scheduler

Study Detail
Visit Templates
Study Subjects
Study Members

Status:

Total Outpatient Visits
Total Inpatient Visits
Total Subjects

Expected Start Date
Expected End Date

Study Details

Overview

Institution		Status
Study Name				Short Name
Industry Initiated		CRC Category		CRC Approved Study?
Expected Start Date		Expected End Date		Adult/Pediatric
Total Outpatient Visits		Total Inpatient Visits		Total Subjects
Actual First Visit Date		Last Scheduled Visit Date
Study Abstract

Contacts

Principal Investigator

Full Name
Credential
Division
Dept
Email Address
Phone #1
Phone #2
Pager

Responsible Physician 1

Full Name
Credential
Division
Dept
Email Address
Phone #1
Phone #2
Pager

Responsible Physician 2

Full Name
Credential
Division
Dept
Email Address
Phone #1
Phone #2
Pager

Primary Scheduling Contact

Full Name
Email Address
Institution
Contact Number

Secondary Scheduling Contact

Full Name
Email Address
Institution
Contact Number

Third Scheduling Contact

Full Name
Email Address
Institution
Contact Number

Protocol Nurse

Full Name
Email Address
Institution
Contact Number

Associate Protocol Nurse

Full Name
Email Address
Institution
Contact Number

Protocol Nutritionist

Full Name
Email Address
Institution
Contact Number

Associate Protocol Nutritionist

Full Name
Email Address
Institution
Contact Number

Identification

Local ID		Catalyst ID		IRB Number
IRB Approval Date		Most Recent IRB Renewal Date		IRB Expiration
IRB Institution
NCT #		IND #		IDE #

Funding

(Must select at least one funding source)

Funding Source 1
Centers and Institutes *
Grant ID		Site Cost Center
Total Direct Dollar Award	$	Total Indirect Dollar Award	$
Project Start Date		Project End Date
Comment

Funding Source 2
Centers and Institutes *
Grant ID		Site Cost Center
Total Direct Dollar Award	$	Total Indirect Dollar Award	$
Project Start Date		Project End Date
Comment

Funding Source 3
Centers and Institutes *
Grant ID		Site Cost Center
Total Direct Dollar Award	$	Total Indirect Dollar Award	$
Project Start Date		Project End Date
Comment

Funding Source 4
Centers and Institutes *
Grant ID		Site Cost Center
Total Direct Dollar Award	$	Total Indirect Dollar Award	$
Project Start Date		Project End Date
Comment

Active Visit Templates
Inactive Visit Templates

Create New Visit Template

Study Subjects

Add New Study Subject

Study Members

Add New Study Member

The use of this application is for business purposes only. Your use of this application is monitored and a record of access may be reviewed by the institution and may be made available to authorized persons, including the subject, upon request. By using this application, you agree to keep any information found within private. Unauthorized use or disclosure of subject PHI (Protected Health Information) is strictly prohibited.

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