Bolivia

Clinical Trial Application	Bolivia Clinical Trial Quote Request
Mandated Coverage	Unknown
Standard Limits	Unknown
Tail Coverage	Unknown
Data Required to Quote	• Clinical Trial Quote Request • Protocol and Informed Consent Form in English • Protocol Title in Spanish • Local Sponsor Representative details (Contact Person Name, Address, Telephone Number and E-Mail Address) No refund for policy cancellation

Clinical Trial Application	Guatemala Clinical Trial Quote Request Guatemala IVE Formulario
Mandated Coverage	Yes
Standard Limits	n/a
Tail Coverage	n/a
Data Required to Quote	• Clinical Trial Quote Request • Protocol and Informed Consent Form in English and Spanish • Protocol Title in Spanish • Local Legal Representative details (Contact Person Name, Address, Telephone Number and E-Mail Address) • Guatemala IVE Formulario must be completed by a Guatemalan entity/local legal representative • No refund for policy cancellation