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PCRP GCP Training Request Form

For any GCP training and other training requests, please complete the form and send to Karen Dela Cruz (Scientific Affairs Committee, PCRP) through email: KarenAnnMarieDela.Cruz@iqvia.com

Name of Requestor / Coordinator

Name of Institution / Medical Society

Contact Details: Tel #

Email address of Coordinator

Date of GCP Training:
Training session: 8:00 am – 5 :00 pm

(Please indicate target date/s. Date of training will be confirmed by PCRP Coordinator.)

For online, please provide details

Objectives / Purpose : (Please check / fill-up with details.)

To conduct Basic / Refresher Course GCP Training To comply requirements for GCP / conduct of clinical trial To comply requirements for hospital accreditation To comply requirements for Epidemiology / Research / Residency / Fellowship research paper

Other purpose, please specify

Target # of attendees: (Please check.)

For online, please specify

We may need to divide the group into 2 sessions

Profile of attendees: (Please check / fill-up with details.)

Others, please specify (i.e. particular dept. / therapeutic area

Clinical Trial Experience

ALL with ongoing/previous participation or experience in Clinical Trials No Clinical Trial experience Mixed (some with CT experience while some none)

Requested date of training is subject to approval / availability of PCRP Scientific Affairs Committee / Speakers Bureau.
Requesting party is responsible for printing the hand-outs / materials / training certificates for the participants.
Requesting party is responsible for the provision of meals (AM / PM snacks / Lunch) for participants / speakers (if applicable) and for other logistical requirements (i.e laptop / LCD projector / laser pointer / whiteboard or flipchart/s with pens, classroom / training room set-up, sound system or online training platform, if online)
PCRP requests maximum of 10 slots be made available for attendees from PCRP during the training.
Once request is received by PCRP, please allow PCRP to schedule the training in 2-3 months. If your request is urgent, please communicate with Karen Dela Cruz ( karenannmariedela.cruz@iqvia.com ) and Maria Rosario Mislang ( maria.mislang@ppd.com )
PCRP does not charge nor will accept any monetary compensation for speakers engaged in the facilitation of training.

Printed Name / Signature

Date (dd / mm / yyyy)

Received by : (PCRP representative)

Printed Name / Signature

Date (dd / mm / yyyy)

PCRP GCP Training Request Form

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Request Form for GCP Training / Workshop

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