| Clinical Trial Application | Ecuador Clinical Trial Quote Request
Ecuador Know Your Customer Form |
|---|
| Mandated Coverage | |
|---|
| Standard Limits | |
|---|
| Tail Coverage | |
|---|
| 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" |
|---|
