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Get Request For Approval To

E 38105 901-448-6070 Fax: 901-448-1512 Instructions: All clinical research activities involving the use of facilities, equipment, and/or personnel of UT Medical Group, Inc. (UTMG) must be reviewed and approved not less than thirty (30) days prior to study initiation. Complete this Request form and submit it with the additional documentation identified on page 3 to the Director, Office of Clinical Research at the above address. I. STUDY Protocol Title: Protocol No.: Sponsor Name: Approxi.

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