Ecuador

Ecuador

Ecuador

Ecuador

Clinical Trial Application

Ecuador Clinical Trial Quote Request

Ecuador Know Your Customer Form

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
• Protocol Title in Spanish
• Local Legal Representative/CRO details (Contact Person Name, Telephone Number and E-mail Address) and RUC number (Ecuadorian Tax ID)
• No refund for policy cancellation

- CRO or Local Legal Representative must provide the completed "Know Your Customer Form"

Costa Rica

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