« Back

Form Approved
OMB Number 0925-0698
Exp. Date 5/31/2017

Public reporting burden for this collection of information is estimated to average 20 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0698). Do not return the completed form to this address.


  1. Complete the form below and click the Continue button.
  2. Items in *RED are required for processing your enrollment.
  3. In order to receive certification for completing this course, you will need to provide your email address and choose a password. It is suggested that you choose a password that you can easily remember.
  4. Note: If you are taking this course to fulfill the Training and Education Standard issued by the NIH for conducting clinical research in the intramural research program, you MUST input your NIH Institute or Center (IC) in the drop down list to receive credit for completing this course.
Registrant Information

*Please choose a statement below that describes your status, by clicking one of the radio buttons.

Contact Information
and ():

*Do you currently work at the NIH?

Yes No

The following fields are only required if your country is The United States:

If you experience technical problems completing this form, please email to CRT2@mail.nih.gov.

This is a website operated on behalf of the NIH CC Office of Clinical Research (OCR). The primary use of information collected at this website is to complete your registration as a student in the Clinical Research Training course offered by NIH. Information collected includes name, email address, mailing address, phone number and affiliation. Information is not shared with external parties. The provision of information is voluntary. Persons concerned about providing personal information at this website may contact the course coordinator at CRT2@mail.nih.gov for assistance to register.

NIH Clinical Center Privacy and Disclaimer Policy

d'Vinci Interactive Privacy Policy