King’s Health Partners Clinical Trials OfficeContact Comment FormShort Study Title:IRAS Number:Investigator (Site Name):

Date of Contact:Type of Contact:Reason for Contact:KHP-CTO Staff Name:Study Site Staff Name:Brief summary of contact and any issues and corrective action:

Signed: Date:

Name and Job Title:

Insert study/document title Contact Comment Form v2.1 (01 Nov 16) Page 1 of 1