Fda Form 3674 - Top Of Page 1 - Uc Davis Health Page 2
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3FDA form 3674 – bottom of page 1
A. This submission does not reference a
clinical study.
B. My study is required to be posted but
I have not listed yet. I will list it in
the future at the appropriate time.
OR
B. My study is exempt from registration
requirements.
C. My study is posted.
List the assigned NCT
number(s) if you check
Box C.
• Signed and dated by the Sponsor. Date in box 15 is the day the sponsor signs the
form! Does not have to match the submission date listed in Box 2.
• Original goes to FDA but make a good copy for yourself!
DTMI Regulatory
Version 2
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