Personalized Clinical Trial Request

First Name* Last Name* E-Mail* Phone Number* Full Company Address Country —Please choose an option—AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArctic OceanArubaAshmore and Cartier IslandsAtlantic OceanAustraliaAustriaAzerbaijanBahamasBahrainBaker IslandBangladeshBarbadosBassas da IndiaBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandClipperton IslandCocos IslandsColombiaComorosCook IslandsCoral Sea IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDemocratic Republic of the CongoDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaEuropa IslandFalkland Islands (Islas Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern and Antarctic LandsGabonGambiaGaza StripGeorgiaGermanyGhanaGibraltarGlorioso IslandsGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHowland IslandHungaryIcelandIndiaIndian OceanIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJan MayenJapanJarvis IslandJerseyJohnston AtollJordanJuan de Nova IslandKazakhstanKenyaKingman ReefKiribatiKerguelen ArchipelagoKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMidway IslandsMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNavassa IslandNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorth SeaNorthern Mariana IslandsNorwayOmanPacific OceanPakistanPalauPalmyra AtollPanamaPapua New GuineaParacel IslandsParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunionRepublic of the CongoRomaniaRussiaRwandaSaint HelenaSaint Kitts and NevisSaint LuciaSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth KoreaSpainSpratly IslandsSri LankaSudanSurinameSvalbardSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTromelin IslandTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUSAUruguayUzbekistanVanuatuVenezuelaViet NamVirgin IslandsWake IslandWallis and FutunaWest BankWestern SaharaYemenYugoslaviaZambiaZimbabwe
 
 

Please Provide A Sample Description to Be Used For Report(s)

Include an identifying number like study#, formula# etc

Sample Description*

SPF Testing Requirements

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FDA FDA- FDA -Water Resistant 40 Minute- FDA - Water Resistant 80 Minute- FDA - Static AS/NZ Australian/ New Zealand AS/NZ Australian/ New Zealand- AS/NZ- Static- AS/NZ- Water Resistant SPF ISO 24444 International Standard SPF ISO 24444 International Standard- ISO 24444 Static COLIPA European / Global Harmonization / Inernational COLIPA European / Global Harmonization / Inernational- COLIPA - Static- COLIPA - Water Resistant- COLIPA - Very Water Resistant
Panel Size 1 Subject2 Subjects3 Subjects5 Subjects10 Subjects20 Subjects
 

In-Vitro UVA Testing Requirements

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FDA Critical WavelengthCOLIPA European / InternationalBoots Star Rating SystemUVA ISO 24443 International StandardAS/NZ Australian / New Zealand
 

Infrared Testing Testing Requirements

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In-vitro IRPFIn-vivo IR Number of Subject Required in Panel
 

Safety Testing Requirements

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HRIPT24 Hour Patch48 Hour Patch Number of Subject Required in Panel 50100200 Cumulative Patch Number of Subject Required in Panel -20 Photo Toxicity Number of Subject Required in Panel -20 Comedogenicity Number of Subject Required in Panel -6 PhotoAllergy Maximization Number of Subject Required in Panel -25
 

For any testing you selected so far, please complete the appropriate field below

Patch Configuration OccludedSemi-OccludedOpen
Dilution Undiluted, or...
Distilled Water? Distilled WaterOther
Signature DermatologistPediatricianGynecologistPlastic Surgeon
Eye Sting Assay Eye Sting Assay Number of Subject Required in Panel -5 Subjects10 Subjects
Facial Sting Assay Facial Sting Assay Number of Subject Required in Panel -5 Subjects10 Subjects
Vaginal Irritation Vaginal Irritation Number of Subject Required in Panel -5 Subjects10 Subjects
Ophthalmology Ophthalmology Number of Subject Required in Panel -30 Subjects60 Subjects

 

Efficacy Testing

Skin Surface Hydration via CorneometerSurface Evaluation of Living Skin (SELS) via VisioscanTransepidermal Moisture Loss (TEML) via DermaLab EvaporimeterSkin Lightening via ChromameterPhotoGrammetrix Analysis, PhGx® Skin Moisturization - Electroconductivity via NovameterSkin Elasticity and Firmness via CutometerSkin Sebum via SebumeterMatched Scientific Photography, MSP™Subjective Questionnaire addressing user perceived benefits

For the testing requested above please fill out the applicable fields listed below:

- -
 

Deo Testing

Antiperspirant TestingDeodorant Testing
Time Points -1 Hour24 Hours48 Hours72 HoursOther Hours Gender -MaleFemale

Submitted By / Authorised Signature

Date