Clinical Registry Data Contribution Agreement

This Clinical Registry Data Contribution Agreement (“Agreement”) is made and entered into as of (“Effective Date”) by and between:

Contributor Name
Contributor Address
Registry Name
Registry Administrator

1. Purpose

2. Definitions

1. “Data” means
2. “Registry” means
3. “Contributor” means
4. “Registry Administrator” means

3. Data Contribution

1. 3.1 Data to be Provided:
2. 3.2 Method and Frequency:
3. 3.3 Data Standards:

4. Data Use and Access

1. 4.1 Permitted Use:
2. 4.2 Data Access:

5. Confidentiality and Privacy

1. 5.1 Patient Confidentiality:
2. 5.2 Regulatory Compliance:

6. Intellectual Property

7. Publication and Reporting

8. Term and Termination

1. 8.1 Term:
2. 8.2 Termination:
3. 8.3 Effects of Termination:

9. General Provisions

1. 9.1 Notices:
2. 9.2 Governing Law:
3. 9.3 Entire Agreement: