<p> DELEGATION LOG (TASKS DELEGATED FROM Responsible Researcher at Institution) Clinical Interventional Study</p><p>Study: (Title and number) Project Manager: Centre No: (Multi centre study) Responsible Researcher at Institution: Task Codes**:</p><p>Role*:</p><p>A. Obtain Informed Consent H. Report SAE O. Review lab results</p><p>Reseponsible Researcher (RR) Other:______B. Assess inclusion-exclusion Criteria I. CRF completion, query resolution P. Allocate treatment/randomisation</p><p>Investigator (INV) Other:______C. Record Medical History J. Sign off CRF and queries Q. Unblind, if applicable</p><p>Study Nurse (SN) Other:______D. Record Concomitant Medication K. Lab sampling and handling R. Other:______</p><p>Lab personnel/bioengineer Other:______Role Name Initials Signature Delegated Protocol- Start RR Stop date RR (pinted) tasks specific date con (dd.mm.åååå) confirmation (from code list) training (dd.mm.yy fir (initials) received yy) ma tio n (init ials )</p><p>RR Yes No Role Name Initials Signature Delegated Protocol- Start RR Stop date RR (pinted) tasks specific date con (dd.mm.åååå) confirmation (from code list) training (dd.mm.yy fir (initials) received yy) ma tio n (init ials )</p><p>Yes No</p><p>Yes No</p><p>Yes No</p><p>Yes No</p><p>Yes No</p><p>Yes No</p><p>Yes No</p><p>Yes No</p><p>Yes No DELEGATION LOG (TASKS DELEGATED FROM Responsible Researcher at Institution) Clinical Interventional Study</p><p>Study: (Title and number) Project Manager: Centre No: (Multi centre study) Responsible Researcher at Institution: Task Codes**:</p><p>Role*:</p><p>A. Obtain Informed Consent H. Report SAE O. Review lab results</p><p>Reseponsible Researcher (RR) Other:______B. Assess inclusion-exclusion Criteria I. CRF completion, query resolution P. Allocate treatment/randomisation</p><p>Investigator (INV) Other:______C. Record Medical History J. Sign off CRF and queries Q. Unblind, if applicable</p><p>Study Nurse (SN) Other:______D. Record Concomitant Medication K. Lab sampling and handling R. Other:______</p><p>Lab personnel/bioengineer Other:______Role Name Initials Signature Delegated Protocol- Start RR Stop date RR (pinted) tasks specific date con (dd.mm.åååå) confirmation (from code list) training (dd.mm.yy fir (initials) received yy) ma tio n (init ials ) Role Name Initials Signature Delegated Protocol- Start RR Stop date RR (pinted) tasks specific date con (dd.mm.åååå) confirmation (from code list) training (dd.mm.yy fir (initials) received yy) ma tio n (init ials )</p><p>Yes No</p><p>Yes No</p><p>Yes No</p><p>Yes No</p><p>To be signed by RR at the completion of the study to confirm all information above is correct (Last page) Date Responsible Researcher, printed name Responsible Researcher, signature </p>