REQUEST FOR QUOTATION

for preparing and installation of

diCELLa eCRF clinical trials system

*Please fill in all the details so that our team can prepare an offer tailored to your needs and expectations*
*If you wish us to contact you for a quote, please fill in the "Responsible person" and "Email" fields.*
Personal information
Responsible person (first and last name):*
Title:
Email:*
Phone:
Institution:
Main information
Request for quotation date:
2024-11-21
Ordering party details:
Website:
The beginning of implementation
We will start the activities for you by receiving the necessary documents from you, including the study protocol. The details are established during the meeting/discussion. Note: it is not necessary for you to provide your CRF, we can prepare it for you based on our knowledge and experience.
The day after transfer of the needed trail documents
Presentation of the first version of the system
At this point, you will receive a demo version of the eCRF system developed from the data provided by you. Then we begin the stage of detailing the eCRf content to ensure the highest possible data quality.
Not later than two weeks from the beginning of the implementation
Finalization of the implementation
Not later than one month from the beginning of the implementation
License length (years)
This is the duration of the planned study, such as 3 years, 5 years, etc.
Priority:
If your request is urgent, please mark it in the form.
Planned start date of the study:
The approximate date of the start of the study, may change later.
EDC features
Number of sites
Location of sites (Poland / EU / USA / other)
Language of eCRF (Polish, English, other)
Planned number of patients
Planned screening failure
Randomization (if appears, what kind)
If randomization is planned in your study select it from the list. If a particular method is not listed here, then write us about it in the comments, or inform us at the meeting
Product tested
Phase
Estimated number of users
Fill in the approximate number of users, including all roles - researchers, coordinators, Monitors, and Sponsors. This will help us properly estimate the price of the product for you.
IWRS
We have extensive experience in integrating the IWRS module with eCRF which allows for the error-free management of medication for patients. If your study requires IWRS, please select this option.
eTMF/eISF
Number of visits
Planned duration of patient's participation in the study (weeks)
Data or/and Imaging data repository
If your study collects any digital data, including test results in text/number or image form, we can prepare a data repository for you that will be connected to the eCRF.
EDC System Management Plan Preparation
Sponsor Staff Remote Training on eCRF
Help Desk Support (including server/web hosting) during the whole project's duration
Coding of Medical History and Concomitant Medications
Interim data review and query handling by Data Manager
Interim Data Export for the Purpose of Interim Data Cleaning
Final Data Review and Query Handling by Data Manager (upon study completion)
Final (pre-database-lock) QC activities including final data export after EDC application lock and database retirement activities
eCRFs documents archiving on CD-ROM for the participating sites upon study completion
Comment:
Write your comment here, all the necessary information that will help us prepare an offer best suited to your needs.
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