Costa Rica

Clinical Trial Application	Costa Rica Clinical Trial Quote Request
Mandated Coverage	Unknown. Please confirm with your CRO.
Standard Limits	n/a
Tail Coverage	n/a
Data Required to Quote	• Clinical Trial Quote Request • Protocol and Informed Consent Form in English • Protocol title in Spanish • Legal Representative in Costa Rica or Local CRO details (Contact Person Name, Address, Telephone Number and E-Mail Address) No refund for policy cancellation

Clinical Trial Application	Belgium Clinical Trial Quote Request Clinical Trials Quote Request
Mandated Coverage	Yes
Standard Limits	Between 400.000 and 600.000 €/patient Between 3.000.000 and 5.000.000 €/protocol
Tail Coverage	3 years
Data Required to Quote	• Clinical Trial Quote Request • Protocol and Informed Consent Form in English • Protocol Title in French • Local EU Representative details (Contact Person Name, Address, Telephone Number and E-Mail Address). Not required if Sponsor is domiciled in the EU.