Forms » E-CT.gov Account Create Request Form
The Clinical Trials.gov Program Administrator is responsible for creating accounts for investigators to access the clinicaltrials.gov protocol registration system to register investigator-initiated clinical trials conducted at VCU in accordance with VCU policy. By completing this form, the principal investigator (PI) or their designee can initiate this process. The PI remains ultimately responsible for ensuring that their clinical trials is registered on clinicaltrials.gov in compliance with VCU policy.
Name: (of person requesting account)
Title: (of person requesting account)
Phone Number: (of person requesting account)
Email: (of person requesting account)
PI Last Name: (if different from requestor)
PI First Name: (if different from requestor)
Please verify the person who should be considered as the record owner and any persons who need access to the record for data entry purposes:
Name of Record Owner:
Title of Record Owner: (e.g, PI, study coordinator, etc.)
Name of Person (s) Needing Access to Record
IRB (HM) #:
Funding Entity Name: Not funded
By clicking “Submit”, this email will be sent to CCTRCTGOV@vcu.edu, which is the Clinical Trials.gov (CT.gov) Program Administrator’s email. You will be contacted by CT.gov Program Administrator if there are any questions.