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Samples, Forms, and Worksheets

1 Samples, Forms, and WorksheetsContentsAdverse Event/Intercurrent Illness LogAdvertisement Sample ApprovedBudgeting by Activity WorksheetBudgeting by Position WorksheetCase Report FormConcomitant MedicationsConfidentiality Letter or Nondisclosure AgreementContact Worksheet for Sponsor and VendorsContract or Clinical Trial AgreementCritique of an Inappropriate AdData Clarification or Query FormDelegation of Responsibility LogDrug Accountability or Dispensing LogDrug Study Announcement MemoFacilities LetterFDA Warning Letter Regarding Advertising

Vital signs 5 5 $3.00 $15.00 Blood draw 10 5 $8.00 $40.00 Lab processing 60 5 $50.00 $250.00 Adverse events recording 10 5 $8.00 $40.00 Concomitant meds recording 10 5 $8.00 $40.00 Patient diary review 20 5 $16.00 $80.00 Dispensing and accounting for study meds 30 5 $25.00 $125.00 Patient instruction 30 5 $25.00 $125.00

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