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To,
Dr. Amey Mane,
Sun Pharma Laboratories Ltd
Sun House, Goregaon east,
Mumbai.
Dear Dr. Mane,
Subject: Evaluation of Lipid levels and Associated Risk Markers in Indian dyslipidemia Patients treated with Atorvastatin (LIPIMAP III) – A retrospective, cross-sectional, real world study
In response to your letter dated _________, I give my consent to participate in the above captioned study bearing protocol number SP/CVD/LIPIMAP-III/RWE-15-2023.
I understand that:
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You will provide me with a copy of the study Protocol and the requisite number of Data Collection forms (DCFs)
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The DCFs will capture data as defined in the Protocol, including laboratory results as prescribed and performed in accordance with my routine clinical practice and no fresh laboratory or any investigations will be conducted for the said study
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I will ensure to capture all available information accurately and completely in the DCF provided
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I understand and agree to allow an independent Contract Research Organization(CRO) to visit the study center and compare the information supplied in the DCF to that in medical records
My personal details are given below for accuracy of your records.
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