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Associates In Research, Inc.

Please fill out the form below to help us better understand your company and study.

1.  What type of study do you want us to conduct?

2.  What are the indications of the study?

3. What drug(s) and/or device(s) would you like us to investigate?

4.  How will you pay for our services?

In payments

One Sum payment

5. Number of participants you need us to enroll:

3-14

15-24

100+

25-99

6. Addition comments about the study:

Contact Information

Company Name

Person Of  Contact

Address:

City:

State/Prov:

Country:

Zip/Post. code:

Phone

Fax

E-mail:

Phone: 559-432-8018
Fax: 559-432-9221
Email: gmacias@assoc-in-research.com