Become an Alcon Clinical Trial Investigator

1. First and Last Name of potential Principal Investigator

2. Credentials:

Medical Doctor (M.D.)

Doctor of Osteopathic Medicine (D.O.)

Doctor of Optometry (O.D.)

Other

3. Email address of Potential Principal Investigator

4. Institution Name

5. City, State

6. Therapeutic Area of Interest (select all that apply):

7. Previous experience as a Principal Investigator on a Sponsor Initiated Trial?

8. Previous participation as a Sub-Investigator or Study Coordinator on a Sponsor Initiated Trial?

9. Please provide Email Address for follow-up by Alcon personnel.

Become an Alcon Clinical Trial Investigator inOphthalmology / Optometry