The NLSDs/TGCV Study Application Form
To participate in The TGCV Study, please fill up the contents below
PARTICIPATION
Participate: □YES / □NO
Number of the subjects:
subjects (estimated) per year
SITE
Name:
Address:
INVESTIGATOR(S)
1. Name:
E-mail:
2. Name:
E-mail:
IRB
Does your site require IRB approval to this study: □YES / □NO
If yes → Date of the approval:
/
/
SYSTEM
Is internet available?: □YES / □NO
Is your PC satisfying the system operating environment?: □YES / □NO
(To check the system operating environment , see the next page)
Is the eClinical Base Web site accessible? : □YES / □NO
(The web site’s URL is shown in the next page)
APPLICANT :
DATE (DD/MM/YYYY):
After filling up, please send this form to the principle investigator’s office by E-mail or by FAX.
E-mail: xxxx@xxxx
FAX: xxxx-xxxx-xxxx
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The TGCV Study System Operating Environment
To use the eCB system for the TGCV study, please use the system in a system operating environment
satisfying the conditions shown below. In case you cannot use the PC satisfying the certain condition,
please contact the Principle Investigator.
1st STEP
Please check whether your PC is satisfying the conditions shown below.

Internet access is available

Satisfying the system operating environment (see below)
<System operating environment>
Windows
Windows XP
Service Pack 2 or above
Windows Vista
Windows 7
Windows 8
Internet Explorer 8
x
x
x
-
Internet Explorer 9
-
x
x
-
Internet Explorer 10
-
-
-
*1
Apple
Mac OS X
Mac OS X
Mac OS X
Mac OS X
Mac OS X
10.4
10.5
10.6
10.7
10.8
Safari 4
x
-
-
-
-
Safari 5
-
x
x
x
-
Safari 6
-
-
-
-
x
x: System operating environment *1: Only the desktop mode can be used




This system cannot be used in a system operating environment (such as Firefox or Opera) other than
that specified above.
To use our system, it will require the Java Script and cookies enabled in your web browser.
Note that, even in the specified system operating environment, the system may not be used
depending on the environment use (such as security software and network environment) and setting
of Internet Explorer.
To view or output PDF, Adobe Reader 8 or above needs to be installed.
2nd STEP
Please access the URL ： https://ecbweb.tri-kobe.org/eClinicalBase/
Click the language selector on the upper right of the screen to Select “English”. (This screen might be
shown in Japanese before selecting.)
DO NOT enter or click other than “Language selector”
Please confirm that you can access the website and whether it is shown like above. In case you cannot,
please contact the Principle Investigator’s office.
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