中華民國開發性製藥研究協會
The Republic of China
International Research-Based
Pharmaceutical Manufacturers Association

Date:	
Submitted by:		
	Name:		
	Title:		
	Company:		
	Tel:		

PMS Registry System

Company Name		
Protocol Number		
Title of Study		
	(in Chinese)	
Primary Objective		
	(in Chinese)	
Number of Sites		
Period of Study
Starting date/
Expected ending date		
Number of Patients		
IRB Approval Date		
Publication Plan/ Date		
*All items must be specified.
Please submit this sheet to IRPMA via email (irpma@irpma.org.tw) or fax (02-2746-8575).
Thank you very much for your cooperation!