ABSTRACT

Signed FDA Form 1572 I IRB approval of Protocol and ICF CV for Principal Investigator IRE3 approval of advertisements 0 CVs for Subinvestigators List of IRE3 members or assurance #

Indemnification

Financial Disclosure for Study Coordinator

Laboratory certification

Signed Protocol Signature Page I Laboratory normal values Draft Informed Consent 0 l Other:

3 1. Record retention

Signature of person who conducted the visit Date

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