Clinical Trial Results Disclosure Form
Sponsor Name
Clinical Trial Title
Protocol Number
ClinicalTrials.gov Identifier
Trial Phase
Phase 1
Phase 2
Phase 3
Phase 4
Start Date
End Date
Population & Methods
Study Population
Methodology
Intervention(s)
Results
Primary Outcome(s)
Secondary Outcome(s)
Results Summary
Adverse Events
Disclosure & Registration
Date of results disclosure
Registry/URL of Results (if applicable)
Additional Comments