Please call our Clinical Trials Manager, Doug Tran, Pharm.D. at 877-444-1133 or send Dr. Tran an email message at doug@mcguff.com.
Please complete all required fields (indicated by bold text).
First Name:
Last Name:
Salutation:
Company or Institution:
Business Address:
Business Address 2:
City:
State: Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virgina Wisconsin Wyoming American Samoa Guam Nothern Mariana Islands Puerto Rico
Zip Code:
Telephone Number:
Fax Number:
Email Address:
Confidentiality Agreement Required? No Yes
Active Pharmaceutical Ingredient (API)?
Chemical Classification of API:
Does the API Require Special Handling Procedures? No Yes
If yes, please specify special handling procedures below:
Is there an IND for your trial? No Yes
If yes, what is the IND Number?
Dosage Form of Study Drug:
Stability Information of Finished Product:
Double-Blind Placebo Control:
Randomization:
Number of Subjects:
Duration of Study:
Level of Service, Documentation and Control Required Compounding Pharmacy cGMP
Expected Timeline?
Other Information Relevant to the Request:
Send me information from the McGuff Family of Companies.
The McGuff Family of Companies values your privacy. At no time will your information be shared, rented, or sold to others.
With a McGuff account you can:
Ask a Pharmacist a Question
I Have a New Prescription
Refill a Prescription