Clinical Trials Forms

6 forms available. Fill online with BeneFill. Auto-fill from your profile and download completed PDFs.

Eligibility Screening / Inclusion-Exclusion Checklist

Study-specific · Study sponsor

moderateDr. sig

Checklist confirming the participant meets all inclusion criteria and no exclusion criteria for the clinical trial.

63% auto-fill22 min saved40 fieldsSubmission guide included

HIPAA Authorization for Research

Institution-specific · Research institution

easy

Separate authorization for use and disclosure of PHI for research purposes. May be broader than clinical HIPAA authorization.

70% auto-fill10 min saved20 fieldsSubmission guide included

Individual Patient Expanded Access IND Application

FDA Form 3926 · U.S. Food and Drug Administration

hardDr. sig

Simplified form for requesting compassionate use of investigational drugs for patients with serious or life-threatening conditions and no alternatives. FDA approves over 99% of requests. Requires manufacturer agreement to provide the drug.

50% auto-fill45 min saved50 fieldsSubmission guide included

Informed Consent Document (ICF)

Study-specific · Study sponsor / institution

hardDr. sig

Comprehensive document explaining the clinical trial: purpose, procedures, risks, benefits, alternatives, voluntariness, and right to withdraw. Must be approved by IRB.

50% auto-fill45 min saved30 fieldsSubmission guide included

Investigational New Drug Application (IND)

FDA Form 1571 · U.S. FDA

very hardDr. sig

Traditional IND application form for expanded access submissions. Form 3926 is the simplified alternative for individual patients.

38% auto-fill90 min saved80 fieldsSubmission guide included

Statement of Investigator

FDA Form 1572 · U.S. FDA

moderateDr. sig

Statement of investigator qualifications and commitment to conduct the study per FDA regulations. Accompanies IND submissions.

60% auto-fill22 min saved30 fieldsSubmission guide included