Health Canada Clinical Trial Site Information Form

The Clinical Trial Site Information (CTSI) form is required to be submitted by clinical trial sponsors prior to initiating a protocol or implementing subsequent amendment(s) at the clinical trial site for trials that are subject to Division 5 of Part C of the Food and Drug Regulations or the Clinical Trials for Medical Devices and Drugs Relating to COVID-19 Regulations.

The following information for the CHIPER can be entered in the Research Ethics Board Approval section.

32. Name of Research Ethics Board, including affiliations (if applicable) (full name, no abbreviations): Research Manitoba CHIPER Research Ethics Board
33. Street Number (required): 753
34. Street Name (required): McDermot Avenue
35. Suite/Unit: A201 Chown
36. City/Town (required): Winnipeg
37. Province/Territory/State (required): Manitoba
38. Postal Code/ZIP (required): R3E 0T6
39. First Name (required): Anna
40. Last Name (required): Glybina
41. Email Address (required): CHIPER@researchmb.ca
42. Phone (required): 1-866-248-4375
43. Language (required): English