Expression of Interest form

EXPRESSION OF INTEREST TO CONDUCT A CLINICAL STUDY

AusCann Group Holdings Ltd, and its wholly owned subsidiary AusCann Operations Pty Ltd (together called “the Company”), are committed to the support of relevant, quality studies for the generation of clinical evidence, in the area of cannabinoid-based therapeutics. Interested investigators/sites may respond by completing this standard form. Responses are used by the Company to facilitate more detailed feasibility discussions with the interested investigator/sites, and at this time additional proposed study information will be shared under non-disclosure agreement.

Site contact details

Principal Investigator

Name *

First

Last

Email *

Phone *

ORCID / ResearcherID / Other *

Main research site contact

Name *

First

Last

Email *

Phone *

Website / URL *

Concept outline ¹

Study Type *

Observational
Interventional

Primary AusCann Drug *

Research Setting *

Single site
Multi-site

Support Sought ²

(indicate all that apply) *

Supply of Investigational Product

Supply of Investigational Product (at cost)

Supply of Investigational Product (sponsored)

Supply of Investigational Product (sponsored)

Funding

Funding

Other support (please indicate):

Other support (please indicate):

Upload accompanying PDF

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Other Support Secured or Sought (eg. grant) *

Study Title (preliminary) *

Brief Study Synopsis *

Brief Study Rationale/Objectives *

Number of Intended Participants *

Indicative Study Timeline

Indicative Study Timeline START *

Start Date *

Indicative Study Timeline END *

End Date *

Any other relevant information

Download EOI Form

AusCann accepts concept submissions and full submissions for Investigator-Initiated Studies (IIS). If a concept submission is of interest a follow-up discussion and progression to a full submission will occur.
AusCann will not support the following:
1. Requests for support for ongoing studies or new research without an associated study
  synopsis;
2. Compassionate supply requests (should be directed to the Company outside this process);
3. General educational and training activities;
4. Start-up funds to establish new clinical or research programs or to expand existing programs;
5. Purchase of capital equipment or any equipment unrelated to the study or which could be used
  to generate revenue;
6. Construction, refit or maintenance costs associated with a facility;
7. Hiring of staff and staff costs unless they are dedicated to the study, and then only for the
  duration of the study.
Note: If the clinical study is approved for support, AusCann will require:
1. HREC/ethics/IRB approval and any subsequent study notifications from the committee;
2. Final study protocol and any updates;
3. Regulatory documentation (including CTN/CTX if applicable);
4. Fully executed IIS agreement.