Investigator Initiated Studies (IIS) Application Form

Dear Applicant,

We thank you for your interest in research with Ziemer devices and look forward to a fruitful collaboration on your research project. For additional information or clarification, contact Ziemer Clinical & Medical Affairs.

Please fill in the following fields and upload the required documents. Please note, that only complete submissions, including all documents listed below, will be reviewed.

List of required documents:

1. Study synopsis, containing:
   1. Investigators’ names and affiliations
   2. Study title
   3. Study site(s)
   4. Research objectives
   5. Brief description of the study
   6. Study design
   7. Planned number of subjects
   8. Statistical considerations
   9. Estimated start and end date
   10. Statement on competing interests
   11. Requested resources
       
       
2. The study protocol (if exists at this stage)
   
   
3. Short CV of the primary investigator (mentioning other completed studies and including list of publications)
   
   
4. An EC/IRB and/or health authority approval (if applicable and available)
   
   
5. Cover letter (optional)