STUDY DELEGATION LOG and SIGNATURE SHEET – SAMPLE …



STUDY SIGNATURE SHEET

Protocol Title:

Protocol Number:

|Name |Signature |Initials |Role1 |Start Date |End Date |

|(please print) | | | |(mmm/dd/yyyy) |(mmm/dd/yyyy) |

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1. PI=Principal Investigator; CI=Co Investigator; CRN=Clinical Research Nurse; CRC=Clinical Research Coordinator; P=Pharmacist

The above persons are working under my supervision.

Investigator’s Signature: Date:

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