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I hereby confirm my interest in participating in Clinical Trials with Clinical Inquest Center Ltd. I understand that participating in any trial is voluntary and may refuse to participate at any time. I also understand that my insurance will neither be billed not I will be charged as a result of participating in these trials. Further I may be compensated for travel and time towards my participation.

I hereby authorize Clinical Inquest Center Ltd and any of its subsidiaries/sites namely Clincare International Center Ltd. to obtain my Health records from any physician, Hospital or health care facility / providers. This authorization will be valid for an indefinite period of time, but I can revoke with a written request anytime to research@cic-america.com

I hereby confirm that I am employed with a sponsor / CRO and intending to work on Clinical Trials with Clinical Inquest Center. I also confirm that I will be keeping all information and credential obtained through this website confidential.

I hereby confirm that I am an employee of CIC AMERICA group of companies, i.e either with Clinical Inquest Center Ltd or Clincare International Center Ltd.

I do confirm that all the information submitted by me is true to my knowledge. I also certify that I can use this website only as long as I stay employed with CIC GROUP of COMPANIES. Any use after my employments ceases to exist, will be considered in appropriate and illegal.