Haiti

Clinical Trial Application	Haiti Clinical Trial Quote Request
Mandated Coverage	n/a
Standard Limits	n/a
Tail Coverage	n/a
Data Required to Quote	• Clinical Trial Quote Request • Protocol and Informed Consent Form in English • Local Representative details (Contact Person Name, Address, Telephone Number and E-Mail Address) and NIF (Haitian Tax ID #) • No refund for policy cancellation

Clinical Trial Application	Slovakia Clinical Trial Quote Request Clinical Trials Quote Request
Mandated Coverage	Yes
Standard Limits	If sublimit, 200.000 €/patient Between 1.000.000 and 2.000.000 €/protocol
Tail Coverage	3 years after the end of patient treatment
Data Required to Quote	• Clinical Trial Quote Request • Protocol and Informed Consent Form in English • Protocol Title in Slovakian • Site List in Slovakian, inclusive of Full Name(s) of Principal Investigator(s), the Hospital(s)/Site Location(s) Address(es) with Area Code