Name of Auditor/Consultant* |
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Nationality* |
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Passport Number* |
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Gender* |
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Date of Birth* |
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Passport Expiry Date* |
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Country of residence |
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Geographical Coverage |
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Detailed Address * |
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E-mail address* |
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Phone Number* |
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Actual Occupation |
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Educational Background* |
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Experience |
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Family of GxP
(include GCP, GLP, GMP, 21 CFR, PV, etc.) |
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No Of audits |
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Main Therapeutic Areas |
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Number of years of experience as auditor |
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Main Phases of Audits in Clinical Research |
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Total Number of Audits Conducted |
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Language(s) in which Audits / Reports can be performed* |
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List of References (Pharma Companies / CROs / Biotechs / Hospitals / Warehoueses / Etc.) * |
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List the Major Clients you worked with * |
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Time needed in advance for Audit request* |
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Time needed to prepare a Complete Report * |
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Fees/day USD * |
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Please attach updated CV with copy of related diplomas and certifications |
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Comments |
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