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Averion's Oncology Business Unit

With more than 25 years of oncology experience, Averion offers its clients dedicated oncology teams.   Learn More. 

 

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Averion’s Investigator Database Sign-Up

Averion is a top 25 international clinical research organization (CRO) with proven expertise in designing, performing and managing drug, biologic and medical device trials. We recruit Investigator Sites around the world to participate in clinical trials for our clients.

Please complete the following profile to be considered for opportunities with Averion. If there is more than one Investigator at your site, please complete a profile for each Investigator.

I would like to participate in clinical research studies with Averion International Corp. and I agree to allow Averion to contact me via email or other means with clinical research opportunities:

  

By submission of this information, on behalf of the site, I consent to the use of this data by Averion International Corp., its Sponsors and affiliated companies for site selection, administrative purposes, and any other purpose required by law.

This profile is being completed by:

Your Last Name:
Your First Name:
 Your Title:

Averion Investigator Profile Form

What is your primary role at this site?

   
      

Other:

Investigator Name:

Last Name:   
First Name:  
Middle Initial:  

Degree(s):

          
                      

Other: 

Title/Greeting:

                

Other: 


Address/contact details where you wish to be contacted with potential studies:


 Company/Office Name:  
 Address Line 1:       
 Address Line 2:    
 City:      
 State/Province      
 Postal Code:   
 Country:      
 Office Phone:      
 Fax Number:   
 Email:      

Please check all of the following Therapeutic Areas for which you have current experience and/or interest in conducting studies:

Experience / Interest Therapeutic Area  Number of Trials Participated in
    
     
     
      
 
    
       
     
     
   
     
       
       
    
     
      
    
    
      
    
     
     
      
      
      
      
      
      
     
      
     
    
 Other:     

What age group(s) does your site see? (select all that apply):

        

How long have you been conducting clinical trials?

I have been conducting clinical trials since:     [None] Select a Date Delete the Date  


What is the total number of trials that you have conducted as a Principal Investigator?

    


What is the total number of trials by phase that you have conducted as a Principal Investigator?

Phase I      Phase II        Phase III       Phase IV   


How much time do you devote each week to clinical research as a Principal Investigator?

          


Does our site have experience with Electronic Data Capture (EDC) studies?

Is the Investigator fluent in English?

Does your site conduct research through a Site Management Organization (SMO) or network?

What type of hospital are you affiliated with?

    
  
    
   

That type of IRB/EC is your site able to use?

      
Central (Independent from your site, example WIRB)  
  

What is your Practice/Research Organization Name:

What type of Practice/Research Organization is it?   (Check all that apply):

        
     
       
    
  Other (please specify):    


 

Number of physicians in the Practice:

Number of physicians in the Practice:   
Number of investigators in the Practice:  

 

What types of trials are you interested in conducting? (check all that apply):

           

    

Please feel free to provide any further information about your site, its experiences and/or interests in the space below:

  

Thank you for completing your profile with Averion. We will contact you when we have upcoming trials that match your experiences and interests based on this profile.