ACTRI Clinical Research Services Request Form Logo
  • ACTRI Clinical Research Services Request Form

  • In order to request ACTRI translation services, please select 'Coordinators' from the above options and enter your specific translation needs in the Coordinator services field!

  • To request other ACTRI Services, please use this link.

    • -- Clinic Location Question Section 
    • If you are unsure about the correct location, please first contact Bernadette Cale (bcale@health.ucsd.edu) and/or Patricia Santana (pmoraes@health.ucsd.edu) to help you determine which location would be the most suitable for your study.

    • -- -- Linda Vista Section 
    • For Linda Vista Clinic:

    • Your study will need a Coverage Analysis (CA) and Velos Record/Calendar set-up for billing and scheduling purposes.

      For CA, please contact ocaa@ucsd.edu (UCSD Coverage Analysis).

      For Velos record, please contact ctri-velos@health.ucsd.edu (https://velos-wiki.ucsd.edu/).

      For additional assistance, you can submit a request above for “Clinical Trials Project Management” services and/or email actri-ctss@health.ucsd.edu.

    • Your study will need a Velos record set-up for scheduling purposes. Please contact ctri-velos@health.ucsd.edu (https://velos-wiki.ucsd.edu/).

      For additional assistance, you can submit a request above for “Clinical Trials Project Management” services and/or email actri-ctss@health.ucsd.edu.

    • Please ensure that your CRC has Velos and ACTRI Clinic access.

    • Only a UCSD-affiliated CRC can conduct research at the Linda Vista clinic location. Please also submit a request for “Coordinators & Language Translation” services above for assistance and/or email actri-coordservices@health.ucsd.edu.

    • -- Reg Support Section 
    • Regulatory Support (IRB Submission)

      Please contact actri-ctss@health.ucsd.edu for any questions prior to submitting your request. For more details on Regulatory Support services, click here.


    • -- Reg Affairs Section 
    • Regulatory Affairs (IND/IDE Submission)

      Please contact actri-ctss@health.ucsd.edu for any questions prior to submitting your request. For more details on Regulatory Affairs services, click here.

    • -- Coordinator Section 
    • Coordinators

      Please contact Len Lazaro for any questions prior to submitting your request. For more details on Coordinator services, click here.

    • -- Clinic Section 
    • Use of Clinic

      Please contact ctri-clinic@health.ucsd.edu for any questions prior to submitting your request. For more details on Clinic services, click here.

    • -- CTPM Section 
    • Clinical Trials Project Management

      Please contact actri-ctss@health.ucsd.edu for any questions prior to submitting your request. For more details on Clinical Trials Project Management services, click here.

    • -- IDS Section 
    • IDS Pharmacy

      Please contact ctri-idspharm@ucsd.edu for any questions prior to submitting your request. For more details on IDS services, click here.

    • Please provide the following sponsor contact information:

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    • -- MRI Section 
    • Imaging Services (MRI)

      Please contact Fang Zhang or Jenna Vuong for any questions (incl. recharge rates) prior to submitting your request. For more details on MRI services, click here.

    • Please upload the follwing documents:

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    • -- DSMB Section 
    • Data Safety Monitoring Board

      Please contact Kathryn Gold, MD for any questions prior to submitting your request. For more details on DSMB services, click here.

    • -- Study Info Section 
    • Study Information

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    • Please upload the follwing documents (if available):

    • In order to evaluate your ACTRI voucher eligibility, at least one of the following documents needs to be attached!

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    • Note: Missing documents require follow-up and will delay the process!

    • PI Information

    • If you are not an ACTRI member yet, please click here to review membership eligibility criteria and submit your application. Once submitted, please select the applicable membership level from the above options to proceed.

    • -- Contact Person Section 
    • Contact Person Information

    • -- Voucher Section 
    • ACTRI Voucher Program

    • As an existing (or pending) ACTRI General or Associate Member, you may qualify for the ACTRI Voucher Program. Please review the ACTRI voucher eligibility criteria and available support levels for details. The below recharge information is required regardless of any subsequent voucher application!

    • The ACTRI voucher capacity has been reached for this voucher period. You may submit your voucher request after the new voucher period begins on May 1, 2024.

    • If you have already submitted a separate voucher request, please do not submit another one!


    • For any additional voucher-related questions, please contact ctri-fin-recharges@health.ucsd.edu prior to submitting your request!

    • -- Recharge Section 
    • Recharge Information

      Please provide valid fund manager and OFC chartstring information for recharge purposes.

      Click here to review current ACTRI recharge rates.

    • Providing incorrect or incomplete OFC chartstring information will require further clarification and delay the process! Contact your fund manager or use the chartstring verification tool (requires VPN connection) to ensure chartstring accuracy prior to submission.

    • ACTRI Backup Chartstring Agreement (click to expand) 
    • ACTRI Backup Chartstring Agreement

      General Approach

      Backup chartstrings will be treated differently from actual chartstrings during the billing process. Any service recharges associated with a backup chartstring will be held back for the duration of up to one (1) year from the date of the first recharge service provided. During this one-year grace period, the PI has the opportunity and obligation to provide an actual chartstring (once available) to ACTRI Finance. If, after one year, no actual (and valid*) chartstring has been provided by the PI, ACTRI Finance will proceed with charging any outstanding balances from services rendered to the backup chartstring. Any subsequent internal fund transfers will be the responsibility of the fund manager of the PI’s home department.

      Backup chartstrings were implemented to accommodate PIs whose studies have not been awarded funds yet due to ongoing contract and/or budget negotiations. However, the obligation to settle any outstanding balances is independent from the successful initiation/execution of a given study/contract. PIs will be charged any outstanding balances from services received either (a) upon provision of an actual chartstring during the one-year grace period or (b) upon expiration of the one-year grace period, using the backup chartstring.

      At ACTRI’s sole discretion, the one-year grace period may be extended in case of any additional contracting and/or budgeting delays that are outside of the PI’s control.

      Site Qualification Management Exception

      All site qualification management services will be automatically recharged six (6) months after service provision, regardless of whether the site was selected or not. Any related IRB submission services will be recharged in accordance with the general approach specified above.

      *) ‘Valid’ means the chartstring is active and chargeable, and the service dates would fall within the start and end date of the chartstring of the fund.

      For additional details on ACTRI Terms and Conditions for Support, click here.

    • -- Backup Chartstring Signature 
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    • -- Reporting Section 
    • Additional Information


    • Industry-sponsored studies are not eligible to receive voucher support. To proceed with your service request, please scroll up to the ACTRI Voucher Program section and unselect 'Yes'.


    • -- Submission Section 
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    • -- Integration Utility Section 
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