Uganda

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

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