Request Clinical Trial Data

To request data from a clinical trial, please fill out and submit the form below. Please also read our Review Process for Data Sharing.

  • Principal Investigator Information:

  • Research Institution Information:

  • Publication Plans:

  • Research Team

  • Description of Qualifications & Experience (attach CV)
  • Description of Qualifications & Experience (attach CV)
  • Description of Qualifications & Experience (attach CV)
  • Description of Qualifications & Experience (attach CV)
  • Description of Qualifications & Experience (attach CV)
  • By submission of this form I agree to the following:*

    • The Information shall only be used for purposes approved by Purdue’s SRB.
    • The Information obtained shall not be transferred to or shared with any party not identified in this request.
    • All research conducted using the Information obtained from this request will be submitted for presentation at a scientific congress or/and publication in a peer-reviewed scientific or medical journal.
    • At least 10 business days prior to submitting any material related to this research for presentation or publication, including any written or verbal communications with print, broadcast or online media, the researcher(s) will allow Purdue to fact check and comment on the material.
    • The Information shall be deleted from all physical and electronic storage not later than three (3) years following publication/communication/dissemination of the research findings or upon researcher’s departure from institution where data are stored (eg, on a department/research center drive or cloud account), whichever occurs sooner.
    • The researcher(s) must agree that anyone with access to anonymized subject-level data/information will not attempt to defeat the data anonymization process.
  • * Required fields.

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Thank you. Your data request has been submitted.

We will contact you within 30 days regarding your submission. Please contact Purdue’s Medical Services Department with further questions by calling 888-726-7535, option #1.

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