SIGNATURE LOG AND DELEGATION OF DUTIES (template) Protocol Name/No: Investigator Name: Sponsor: Start Date Print Name Signature Sample Function (e.g. Task Authorised by End date of Of Initials sub-investigator, Delegated Investigator Involvement Involvement nurse) (initial+ date) Informed discussion Investigational product accountability Informed consent sign off Randomization (e.g. IVRS) Essential / Regulatory documents CRF/Data query completion and correction handling CRF/Data query sign-off Study specific procedures Specify: – Subject Examination/evaluation Other Investigational product dispensation
SIGNATURE LOG AND DELEGATION OF DUTIES (template) Protocol Name/No: Investigator Name: Sponsor: Start Date Of Involvement Print Name Signature Sample Initials Function (e.g. sub-investigator, nurse) Task Delegated Authorised by Investigator (initial+ date) End date of Involvement Informed discussion Investigational product accountability Informed consent sign off Randomization (e.g. IVRS) CRF/Data query completion and correction Essential / Regulatory documents handling CRF/Data query sign-off Study specific procedures – Specify: Subject Examination/evaluation Other Investigational product dispensation
template_sig_log_delegation_of_duties.docx