Spanish Translation Center

RASCAL PT-TrakID Brief title
Submitted by       Created   Modified  

Principal Investigator
Name: Telephone: Pager: E-mail:

Part 1. To be completed by submitter.
Study IRB number CU account #
Sponsor type Department

Date submitted E-mail document(s)
Type of service # pages submitted
Fee for service $ Working days Estimated approval date

Services and Rates
    Any sponsor: $150 per page ($150 minimum)
    Any sponsor: $40 per page ($40 minimum)
 Review and edit of translation done outside of STC
    Any sponsor: $40 per page ($40 minimum)
 Certification of Translation None
 Rush None
    I agree to pay the fee quoted by the STC
Form is not yet complete.  Do not yet forward information to Clinical Trials Office.
Form is complete.  Forward information to Clinical Trials Office.

Part 2. To be completed by the STC.
Date received     # pages received Date initiated     
Translated by     Approved by   Date approved   
Variance (days) Fee for service $

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