Skip to main content

Please take a moment to complete this questionnaire regarding your interest in leading an industry-sponsored trial. This information will help the Center for Women’s Health Research determine next steps for coordination with the Office of Clinical Trials, the sponsor, and administration. Once this form has been submitted, a member of our staff will respond within two business days. If you are submitting a grant application, please use this form.

If you have any questions or concerns, please contact Jalimar Gonzalez (jalimar_gonzalez@med.unc.edu).

  • Name of Company
  • Email address for point of contact is preferred
  • Phone number for sponsor point of contact is preferred
  • Accepted file types: jpg, gif, png, pdf, doc, ppt, Max. file size: 98 MB.
  • Accepted file types: jpg, gif, doc, ppt, pdf, xls, xml, csv, ppt, Max. file size: 98 MB.
  • Accepted file types: jpg, gif, doc, ppt, pdf, xls, xml, csv, ppt, Max. file size: 98 MB.
  • Telephone or Email