Physician Research Network, Inc.

Clinical Research | Training Center | Membership

Membership

Physician Research Network Brings a Unique Value Proposition to Both Pharmaceutical Companies and Physicians

"A student by definition doesn't know what he or she doesn't know."
- Michael Gorman

PRN Membership is open to all physicians and clinical research investigators. To become a member of the network, and be eligible for participation in clinical trials, please fill-in the following brief application (a detailed participation package will be sent to you within 7 days of your request). After completion of this application click on Submit.

Please Fill Out The Application Below:
* Indicates required fields.

Personal Data:


* First Name:	MI:	* Last Name:

Degree:		Board:

Address:

* Telephone:	Fax:	* E-Mail:

Telephone 2:

Practice Information:


Type of Practice: (Private, Managed Care, Group, IPA)

Primary Patient Population Number:

Secondary Patient Population Number:

Research Experience: Clinical Area(s)

Number of Years:

Number of Office Staff:

Number of Research Staff:

Date of Availability to participate in clinical trials: