Page 1 of 1
Patient recruitment campaign - Scoping questionnaire (site)
Name
*
Email
*
Phone
*
Organisation
*
Study Name
*
Key I/E criteria
*
Protocol Synopsis (optional)
Click to choose a file or drag here
Total recruitment period (FPI-LPI)
*
*
Previous recruitment rate for similar indication (per month)
Expected SF rate
How many referrals can be followed up at your site weekly for this study? (Called and appointment booked)
How many patients can be screened at your site weekly for this study?
Are there any satellite sites and if so how many for this study?
*
Please describe any other notes, difficulties or previous successes you have had with recruitment in this indication
*
Is there an approved or allocated advertising/recruitment budget, if so what is it?
Is the sites preference performance based or a fix fee model
Is the sites preference performance based or a fix fee model
A
Performance Based
B
Fixed-fee
C
Mixed
D
Unsure
Performance based: Fee charged as per referral and screened/randomised basis
Fixed-fee: Monthly ongoing fee or retainer for recruitment and advertising
Mixed: A combination of performance based and fixed fee
Submit