Moldova

Clinical Trial Application	Moldova Clinical Trial Quote Request Clinical Trials Quote Request
Mandated Coverage	Yes
Standard Limits	Between 5.000 and 10.000 €/patient Limit per protocol = limit per patient x number of patients
Tail Coverage	n/a
Data Required to Quote	• Clinical Trial Quote Request • Protocol and Informed Consent Form in English • No refund for policy cancellation

Clinical Trial Application	Uganda Clinical Trial Quote Request Clinical Trials Quote Request
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 • Legal Representative details of Sponsor ((Contact Person Name, Address, Telephone Number and E-Mail Address) • Completed Know Your Customer (KYC) Form and Proposal Form to be provided separately • Premium payment is due in advance of release of policy documents No refund for policy cancellation