Submit an Anticipated Clinical Trial Milestone or Data Readout

Company Name*

Product Name*

Technology Type*

Indication*

Are you expecting to submit an IND/CTA or receive IND/CTA approval for this product?*

When do you expect to submit your IND/CTA?*

When do you expect to receive IND/CTA approval?*

Are you expecting any of the following:*

An anticipated upcoming trial milestone (such as initiating the trial, completing enrollment, or dosing a patient)
An anticipated upcoming readout of new clinical data
An anticipated submission or approval of a BLA, MAA, or other marketing application
No

If applicable: what is the NCT# from clinicaltrials.gov for this trial?

What clinical phase of development is your product in?*

What upcoming trial milestone are you anticipating?*

If other is selected, please specify the milestone:*

When do you expect to initiate the trial?*

When do you expect to complete enrollment?*

When do you expect to dose the first patient?*

When do you expect to dose the final patient?*

When do you expect to complete dose escalation?*

When do you expect to complete your specified other milestone?*

When do you anticipate providing the clinical data readout?*

Are you expecting to submit a BLA, MAA, or other marketing application:*

When do you expect to submit in the U.S.?*

When do you expect to submit in the EU?*

In what other country are you seeking marketing approval?*

When do you expect to receive market approval in this country?*

Are you waiting a decision in response to your marketing submission*

When do you expect to receive a decision in the United States?*

When do you expect to receive a decision in the EU?*

From what other country are you waiting on a decision regarding marketing approval?*

When do you expect to receive a decision in this country?*

Is there any additional information you would like to provide?

Please provide a contact email in case additional information regarding your submission is needed.*