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Referral Manager  
Sample Transfer Agreement

Sponsor XYZ Pharma
Protocol Number XYZ1234
PPD Study Code X01
STA Version 1     14-Feb-2008

PPD Lab Global
PPD Project Manager GCL-US: Andy Handy, +1 859 781 8800 ext 111, andy.handy@mrli.ppdi.com
GCL-EU: Christophe Watkins, +32 2 416 40 11, christophe.watkins@mrli.ppdi.com
PPD Specimen Manager GCL-US: Sherry Merry, +1 859 781 8800 ext 222, sherry.merry@mrli.ppdi.com
GCL-EU: Nancy Drew, +32 2 416 40 11, nancy.drew@mrli.ppdi.com
Visits to be Shipped Visit 1, Visit 2, Visit 3
Assay Serum MP
Test name on PPD Label  
Frequency of Shipments Monthly
Estimated Number of Samples
 in Each Shipment
250
Estimated First Shipment 01-Apr-2008
Turn Around Time for Results
 after Receipt of Samples (Days)
 

   
Agree
Disagree
 
Sample Type Serum
 
Shipment Condition Frozen
 
Electronic File Transmission Email
 
Electronic File Type CSV
 
Electronic File Content Sample ID
 
Randomization Number
 
Initials
 
Visit
 
Collection Date
 
Comments
 
Courier Preference
TNT
DHL
FedEx
Other     
Notification of Incoming Shipment
Fax
Email
Terms of Agreement
"Name of Lab" agrees to the terms of agreement to be a part of the PPD Marketplace.
Electronically signed on:
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