Page 487 - CHST Research Administration eBook 2 of 2 (Q4 2021)
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End of Study Summary Worksheet
(Submit a copy of this completed form within 30 days of study closure and when records are sent off site and for long term storage (i.e., Iron Mountain).
Today’s Date:
Person completing this form: Principal Investigator: Sub-Investigator(s): Coordinator:
Title of Study
Sponsor/CRO: Product/Indication:
IRB number:
Velos number:
ERGO NR3 number (if applicable):
Study Status: Study Start date: Study End date: Number enrolled: Concerns (if any):
Long term storage record number: (place stickers here)
April 2, 2019
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