What is the unit of randomisation e.g. participant, site, GP practice, hospital Blocked only Minimised only Randomisation method (tick one only): Stratified + Stratified + blocked minimised Yes Will the block size be randomly varied? No If No, specify size (tick one only): Target Number to be Name randomised (please for potential drop outs) Arm 1: Arm 2: per trial arm Arm 3: Arm 4: Arm 5: Arm 6: Is this a CTIMP trial (i.e. a clinical trial of an Yes No Investigational Medicinal Product)? If Yes, please name all IMPs: If Yes, is a trial prescription to Yes No be generated by the system?
What is the unit of randomisation e.g. participant, site, GP practice, hospital Randomisation method (tick one only): Blocked only Minimised only Stratified + blocked Stratified + minimised Will the block size be randomly varied? (tick one only): Yes No If No, specify size per trial arm Name Target Number to be randomised (please for potential drop outs) Arm 1: Arm 2: Arm 3: Arm 4: Arm 5: Arm 6: Is this a CTIMP trial (i.e. a clinical trial of an Investigational Medicinal Product)? Yes No If Yes, please name all IMPs: If Yes, is a trial prescription to be generated by the system? Yes No
wpd-15-1-randomisation-request-form-final-version1.1-05-jul-2016-1.docx