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In order to estimate the cost of database setup, configuration and data management services for web randomization, we require the following information.

** Please complete one copy of this form for each study estimate required.**

Project information

Project name or title
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Contact information

First and Last Name(Required)

Project specifications

Number of anticipated subjects (study sample size)
Duration of database access
Setup
Max. file size: 512 MB.
CDISC
MedDRA coding
WHODrug coding
IWRS (Web randomization)
Drug Management
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