Date: {{$ActivityAssignDate}}

Subject: {{$ActivityName}}


In response to your letter dated _________, I agree to participate in the study as outlined by you. I understand that:


  • You will provide me with a copy of data collection form.

  • The patients’ identity will not be disclosed in the DCF

  • You will provide the assistance of a monitor to verify and to collect the DCF.


My personal details are given below for accuracy of your records.

Name: {{$doctorName}}
Qualifications:
Speciality:
Postal Address:
PIN Code :
Clinic/Hospital Tel. No. :
Mobile No. :

Yours sincerely,

[Signature & Stamp]
{{$doctorName}}