ࡱ>  ',bjbj n_n_k#  84 w^$(666h Z $ =v?v?v?v?v?v?v$hy|cv F F " cv66xvJ~%~%~% X66=v~% =v~%~%i nUn|<R!k:)vvH wk|"|tnnb|!o ~% cvcv# w |  X v:  ϲ Insurance Registration Form: Interventional Clinical Studies What is covered? The insurance for all ϲ sponsored studies is provided by a commercial insurer. The insurance policy provides two types of cover for all studies: Cover for claims against ϲ for negligence by research participants and others. Cover for non-negligent harm to study participants that is compensation to participants where negligence cannot or is not proven. A note summarising the terms and conditions of the policy and a cover note are available from  HYPERLINK "mailto:jro.sponsorship@ucl.ac.uk" jro.sponsorship@ucl.ac.uk Studies where the insurer needs to be notified before cover is provided. For most studies - CTIMPS and non-CTIMPs, cover is automatic, and we are required only to provide the insurer with a list of all studies covered by the policy. This list is provided by the JRO and contains all ϲ sponsored studies registered with the JRO. However, for a minority of studies, in certain categories, the insurer requires prior notifications before cover can be provided (see section 2). These studies will only be covered following referral and satisfactory review of the protocol/ICF and approval by the insurers. Where a protocol, Participant Information Sheet (PIS) / Informed Consent Form (ICF) are not available, as the trial is being costed for a grant submission, the insurer will request a trial synopsis. The insurer requires information in lay terms using straightforward explanations, such as you would use when explaining a study to a participant when seeking informed consent. Where studies are referred to the insurer, the insurer may: Decide that the study can go ahead with no further conditions. Decide that the study can go ahead but will be subject to additional premium. Refuse to provide cover. An insurance registration form must be completed for each study. The purpose is to identify those studies where cover is not automatic and where the insurers approval is required before sponsorship can be agreed. Completing and updating the form This form should be completed prior to grant application as additional insurance may be required and will need to be costed in. The form should be updated and re-reviewed if any of the participant or site details are amended substantially during the course of the trial, requiring a re-review of the current insurance in place. If the insurers approval is required and agreed, a confirmatory email will be sent by the insurer to the JRO/relevant CTU contact, which will be filed in the TMF/Sponsor File. Who to contact /submit completed form and/or queries to? For trials involving the NHS or social care setting: The JRO or relevant CTU contact administers this form on behalf of ϲ. All queries relating to ϲʒs insurance provisions, additional cover and local policies (where needed for international sites) and the completed form should be directed to your JRO or CTU contact. For all other trials please discuss with the ϲ Research Ethics committee Who should complete the form? The Chief Investigator should complete this form, though this may be delegated to a member of the CIs research team or the JRO/CTU study contact if they fully understand the details of the clinical study or trial. For each trial complete sections 1 and 2 below. SECTION 1: GENERAL INFORMATION QuestionResponse (If the space in this column is insufficient, please expand the table.)1Trial Title and EDGE number (if registered) 2Name of Chief Investigator (CI) for the study/trial. 3Does the CI for the study/trial hold a ϲ contract?Substantive  FORMCHECKBOX  Honorary  FORMCHECKBOX  No ϲ contract  FORMCHECKBOX 4If the CI is not a ϲ employee, please give full contact details of the employer where the CI holds a substantive contract.Employer: Address: Email: Tel: 5For ϲ Student projects only: If you are undertaking a student project as a ϲ registered student, please provide name and contact details of your academic supervisor.Name of supervisor: Dept: Email: Tel: 6Are any of the sites in the UK private or non-NHS hospitals or private care homes? If yes, list site details Yes  FORMCHECKBOX  No  FORMCHECKBOX  Sites:7Do you intend to enrol private patients in NHS hospitals? Yes  FORMCHECKBOX  No  FORMCHECKBOX   SECTION 2: To be completed for all studies IDENTIFYING STUDIES THAT REQUIRE SPECIFIC APPROVAL FROM INSURERS If you are enrolling to any of the following study types, then a referral to the insurer will be required: For Clinical Trials (CTIMPs) or other interventional studies which aim to enrol pregnant women. For Clinical Trials (CTIMPs) or other interventional studies where the study enrols children under 5 years of age at the time of entry. For Clinical Trials (CTIMPs) or other interventional studies with over 5000 research subjects. For Clinical Trials (CTIMPs) or other interventional studies with international sites. For Clinical Trials (CTIMPs) involving a Cell/Gene Therapy medicinal product including gene editing. For Clinical Trials (CTIMPs) or other interventional Covid Trials. For Clinical Trials (CTIMPs) or other interventional studies with therapies targeting the brain, blood-brain-barrier or cerebrospinal fluid. 1Please list: - all of the participating countries - anticipated number of sites per country - anticipated numbers of patients per country (Add rows where necessary or supply as a separate list) - Please supply total numbers of sites and of patients you are planning to recruitCountry(ies) Number of sitesNumber of PatientsTotal2Is the study a CTIMP or other interventional study?Yes  FORMCHECKBOX  No  FORMCHECKBOX 3Is the study a CTIMP involving a cell/gene therapy medicinal product/gene editing?Yes  FORMCHECKBOX  No  FORMCHECKBOX  4Do the inclusion criteria for the study include a requirement for the research participant to be pregnant? If yes, please provide brief details including whether the trial is primarily concerned with the health of the mother, or that of the unborn child. Details:  Yes  FORMCHECKBOX  No  FORMCHECKBOX  5Will there be children aged under 5 at the time of entry in the trial? Yes  FORMCHECKBOX  No  FORMCHECKBOX  6Is the study a CTIMP or interventional study involving Covid vaccines? Covid patients?  Yes  FORMCHECKBOX  No  FORMCHECKBOX  FORMCHECKBOX  Yes  FORMCHECKBOX  No  FORMCHECKBOX  FORMCHECKBOX 7Is the study a CTIMP or interventional study involving therapies targeting the brain, blood-brain-barrier or cerebrospinal fluid? Yes  FORMCHECKBOX  No  FORMCHECKBOX  FORMCHECKBOX 8Is it the intention that the Trial will be sponsored by an institution other than ϲ? If yes, Sponsor Name: ..  Yes  FORMCHECKBOX  No  FORMCHECKBOX  FORMCHECKBOX  9Does the study involve a ϲ manufactured Product? * If yes, please complete the Product Liability form. * Product (or Products where applicable) mean goods including containers, packaging, labels and instructions accompanying the Product manufactured, sold, supplied, distributed, altered, constructed, repaired, serviced, designed, tested, installed or processed by or on behalf of ϲ. Please complete the Product Liability insurance registration form even if you have outsourced the manufacturing to an external organisation or if your product is an app / Software (Medical or otherwise).Yes  FORMCHECKBOX  No  FORMCHECKBOX  FORMCHECKBOX  10Will a ϲ affiliated CTU be managing the Trial? If yes, Name of ϲ affiliated CTU: ..Yes  FORMCHECKBOX  No  FORMCHECKBOX  FORMCHECKBOX   Name of person completing the form: . Post: Email: Date: Please email the completed form to the ϲ sponsorship point of contact for your trial (e.g. JRO Sponsorship Officer, JRO Sponsor Regulatory Advisor or CTU contact) SECTION 3: To be completed by JRO Representative / CTU contact DEPARTMENTAL REVIEW / DECISION Is referral to insurer needed? Yes  FORMCHECKBOX  (complete following sections) No  FORMCHECKBOX  FORMCHECKBOX  (automatic cover applies, complete reviewer name/date at end of table)If yes: Reason Date referral undertakenAdditional insurance provision needed?Yes  FORMCHECKBOX  No  FORMCHECKBOX  FORMCHECKBOX If yes: Details of cover obtained. Attach email from insurer with insurers quote and requirements to this document.Date insurance confirmed by insurer following referralForm review completed by: (To be completed by JRO Sponsorship Officer, JRO Sponsor Regulatory Advisor or CTU Representative)Full Name: Position: Date:       ϲ Insurance Registration Form Interventional Clinical Studies V20, 02.01.24 Page  PAGE \* Arabic \* MERGEFORMAT 4 of  NUMPAGES \* Arabic \* MERGEFORMAT 6  "1:ABCDEFVWXͻ|xjYLLB5hohEg56\]hRk56\]hohRk56\] hb9h,56CJ\]aJhf56CJ\]aJhhUc5B*CJ\aJph#h#Eh#E5B*CJ\aJphh5B*CJ\aJphh#E5B*CJ\aJph#hahRk5B*CJ\aJph h,hRkB*CJ\aJph#h,hRk5B*CJ\aJphhh 5B*CJ\aJphCDEWX? "  $ ] ^`a$gdC$$ ] ^`a$gdGQ$ & F h ] ^`a$gdGQ$ V] ^Va$gdGQ$^`a$gdEg $xa$gdP $^a$gdb9Xr| = > ? I V _ e v   " $ ) 3 C b m p hb9h&0JCJhb9h&CJjhb9h&CJUhb9hOCJhb9hu8CJhU<hU<CJhb9hECJhb9h^{CJhb9hSCJhb9hRkCJaJhb9h)iCJhb9h?CJhb9hRkCJ/      ! + K U    3 C    ȿȶȭȤȞȕzqqqh!hknhCJh!h CJh!hMbCJhb9h,rCJhb9hfCJ h4hCJhb9hxCJhb9h^{CJhb9h)iCJhb9h7CJhb9hRkCJhU<hU<56CJ\]hb9hRk56CJ\] hb9hu856CJ\]aJ, !o`a$']'^a$gdGQ$ ] ^a$gd,$ & F 8^`a$gdGQ$^`a$gdEg$ ] ^a$gdC$$ ] ^`a$gdC$$ ] ^`a$gdC$     # - . / 1 3 7 = > ? 3I\`i{ !(>?@DGHLbfnoʸhb9h CJ h4hCJhb9hRkCJaJhb9hRkCJh!hrCJh!hRkCJh!h4hCJh!h!CJh!hq9CJh!hMbCJh!h CJ>'3=>?DFI^_`ab{(/ʾuiihb9h(eyCJ\]hb9hY6CJ\aJh4h6CJ\hb9hYCJ\]hb9h(ey56CJaJhb9h9T56CJhb9h(ey56CJhb9h"JK5CJaJhb9h9TCJhb9h>CJhb9h^jCJhb9hRkCJhb9h49CJhb9hOCJ)9IJiAqstgdRk$ x] ^a$gd, $x^a$gdGQ $^a$gdGQ$^`a$gdEg$']'^a$gdGQ$ ] ^a$gd,$  ] ^a$gd,/>?'03=>?Ӻuܾ9<5CJ\hb9h4R"5CJ\hb9h4R"56CJ\]h%+/3;<=BDHIJ`hi{$:;<?@¶¤hb9hWCJhb9h}CJhb9hRkCJhb9hRk56CJhb9h"JKCJhb9hy5CJhb9h4R"5CJhb9h;CJhb9h35CJ\hb9h4R"5CJ\;@AB^pqrst  !"#$%Ⱥ}wsookeeeeeassssh aO hZCJhZh"JKhRk hRkCJhf5CJ\hRk5CJ\ hRk5\h[Oht)|5B*\phh!|5B*\phhRk5B*\phh[OhRk5B*\phhEg5B*CJ\phhb9hRk5B*CJ\phhb9hWCJhb9hW5CJ\ hCJ$=kd$$Ifl F;V]&f 0)    44 lapytGQ $IfgdRXgdRk!"#$%'_kd$$IflF;V]&f0)    44 layt, $Ifgd aO $IfgdRX%&'2GKZ[\]^_`ab ̳̥h-x^JaJh(hRk>*^JaJh,ohRk^JaJjhgxhRkUjhgxhRkUjhgxhRkU hgxhRkj6hfkUhfkjhfkU hRkaJhPh]4hRkh !4'\]^_ $IfgdRXJ$Eƀ)uIfgdRX_`bqhh\\\ dh$Ifgd? $IfgdRXkd$$IflF;V]&f0)    44 laytGQxqhhhhhhhhhh $IfgdRXkd$$IflF;V]&f0)    44 laytGQ <CDGKbwx2GIJK^_`abghijltuȻȷȯȝșȕȑȍȑhfkh?Sh aOh]4 h6VphRkh6VphRk5>*\hRk5>*\h !h02hbj[^Jh`hhRkh`hh}5\^JaJh`h^JaJh}^JaJh,ohRk^JaJh,ohb^JaJ7K`abijh________ $IfgdRXkd?$$IflF;V]&f0)    44 laytGQ $Ifgd`h jltu{|}h_ $Ifgd`hkd$$IflF;V]&f0)    44 laytGQ $IfgdRX u{|}~  "#$%&FGJafguvw}~h- 5]^JjhfkUjXhRkU h`hh`hjhgxhRkUjhRkUjhfkUhfkjhfkUh`hhch !hRk=#$&ah____ $IfgdRXkd$$IflF;V]&f0)    44 laytGQ $Ifgd`hopqlcll[RMgdG;^;gdEg$a$gdRk UgdxgdRkkd@$$IflF;V]&f0)    44 laytGQ#2;CGmnops6Ǿ嵵屭hl h!h! hShThEghOh)'hnhGhW5]^JhG5]^Jhw5]^Jh.5]^Jh Bh.6\^JhRk5]^Jhxh !^Jhx5]^J7pZyLMNP^o $IfgdK$a$gdRk^gd & F~]~^gdEgo3 & F~]~^gdEg6=@AWXYZ^acl %)0389;<@ABFGNR_vxy}¾ hSh`O hShc hAhc h`O5\ h5ih5ih`OhPZh5ihU  hShdh: hShU hlh? hSh? hSh hShTh3k hSh: HKLMNOP^egh +89=Jgnopqxĺ➖hF_eh7 5h7 h1h>;6] hBK?6] h)'6]h"h>;6]h)' h"hBK?hBK?hbhW h"h>;h>;h !hRkhpg hq9h`O hq9h9opq~{{{r{ $IfgdF_e $IfgdK{kd $$Ifl0&7'0*44 layt,x}~  #+ǼǮǼǠ֜hlh5ij2 hbDh$DUj hbDh$DUjhbDh$DU hbDh$Dh=hU h$Dh !h-xh7 5hF_eh7 5h7 h7 h7 5 hBK?5<^UE<U $IfgdF_e$$If^a$gdK $IfgdKkd $$Ifl\&730*44 layt,^UE<U $IfgdF_e$$If^a$gdK $IfgdKkdq $$Ifl\&730*44 layt,^UI9U$$If^a$gdK $$Ifa$gdW $IfgdKkd: $$Ifl\&730*44 layt,^ULU $Ifgd)' $Ifgd(ikd $$Ifl\&730*44 layt,pqh_Vh $Ifgd5i $IfgdC$ $Ifgd(ikd $$IflF&7 30*    44 layt,+,12>CKLPUZabnopuv     $ & ( , - . / 1 3 x 渴hh]4hJmhRk5h=hGhbDhRk h~hRkjh5ih5iUjEh5ih5iUjh5ih5iUh5ihC$ h5ihJ8h`O h5ih5i:  qhhhhhhhhhhh $IfgdRXkd-$$IflF&7 30*    44 layt, ! !!!!!"!%!'!+!,!-!.!0!1!6!7!>!?!E!F!G!M!N!\!]!^!_!`!a!ƿ迿j2h+shRkUjh+shRkUjh+shRkUh h+shRkh5ij@hRkUjhRkUjhRkUhRk hRkCJ hqhh5\8 1!_!`!\K & F$If^gd4hkd$$Ifl]F&7 30*    44 lapyt, $IfgdRX`!a!c!!!!!!qhZZMMD $Ifgdj H & F$Ifgdj H$Ifgd`Oo3 $IfgdRXkd$$IflF&7 30*    44 layt,a!b!c!n!o!}!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!"" """"""")"*"+",":"߸ߪߜߎjh`Oh`OUjqh`Oh`OUjh`Oh`OUjh`Oh`OUjEh`Oh`OUjh`Oh`OU h`Oh`OhA hj HhAhF hj Hh`Oh`O8!!!!=">"@""\SE$Ifgd`Oo3 $IfgdRXkd$$IflF&7 30*    44 layt, d$Ifgd, $Ifgd`O:";"<"=">"?"""""""""""""""""""""""""""""#######3#<#=#B#]#^#_#i#k#m#q#s#t#Ϳͱͣ۟ h !h ! h !6]h !hRkhjh`Oh`OUjh`Oh`OUj<h`Oh`OU h`Oh`O hj Hh`Oh`O h+sh`Ojh`Oh`OUj)h`Oh`OU5"###]#^#_####h____V__ $Ifgd ! $IfgdRXkdh$$IflF&7 30*    44 layt, $Ifgd`O t#w#x#y#z#|#~##################################$$ $ $$$ $"$%$&$)$4$7$<$=$>$?$@$௯h.h,CJ^Jhb9hCJaJhEghhPjhRkUj{hRkUjhRkUjhRkUhRkhRhRk6] h !6] h !h !hG9#########$ $h___ $Ifgd{Nkd3$$Ifl`F&7 30*    44 layt, $IfgdRX $=$>$Z%&&e&f&g&j&&h_V $Ifgd ! $IfgdRXkd$$IflF&7 30*    44 layt, $Ifgd{N @$J$\$g$$$$$$$$$$$$$$$$$$$$%% %%%%%!%"%)%*%8%A%B%R%T%U%X%Y%Z%g%u%v%%%%%%%%%%%%%& &%&&&+&,&-&:&;&jhFhUjhFhU hFhhhCJaJhCJaJhusCJaJhb9hCJaJh,CJaJhSh,CJaJB;&<&B&C&Q&R&S&T&X&]&_&b&c&d&e&f&g&i&j&&&&&&&&&&&&&&&&&&&&&&'' ' '''''''''!'3'8'žɶɫɶɠɕɑh6hah jch !Ujh !Ujh !Ujh !U h !h !hGh !hjhFhUjFhFhU hFhjhFhU6&&&&'''''RMMgdRkkd$$IflF&7 30*    44 layt, $Ifgd ! $Ifgd ! $IfgdRX''I'J'b'c'd''''''L(M(N(O(P(Q(S(U(((((( <<$Ifgd(igd!| Ngd}Rgd}RgdRk8'D'H'I'J'P'Q'R'S'T'U'V'W'X'Y'Z'['\']'^'_'`'a'b'c'd'f'i'z'''''''''''''''''''''''(((ŸhF_eh\5B*phhF_ehy5B*phhF_eh5B*phhF_ehG5B*phhG5B*ph hY hRkhRkha h}Rh}R h h h h}RhEghIFh 5(( (#(%()(*(+(,(.(0(:(<(>(?(A(B(I(J(K(L(M(N(O(P(Q(S(T(U(](^(_(`(a(h(r(v(w(~(̿櫡wnbbbbbh#h!|6\^Jh!|6\^Jh!|h!|6\^Jh!|5]^JhEg h}Rh}Rh}R6B*ph.th$D6B*ph.th65B*phh15B*phhF_ehC75B*phhF_eh 5B*phhF_eh\5B*phhF_eh5B*phhkh\5B*ph&~((((((((((((((((((((((((((((() ) )³qff[fQhVD5B*phh1h1B*phh1hVDB*ph'jvh"h$D5B*Uph!jh"h$D5B*Uphh"h$D5B*phh"h$D56B*^Jphh"h$D5B*^JphhEg6B*ph.th!|6B*ph.th!|5]^Jh!|h!|5]^Jh!|6\^Jh#h!|6\^J( ) ))))))m`K> <<$IfgdS & F<<$If^gdh <<$Ifgd(ixkd$$Ifl0&%y0(64 laytGQo$If^o`gdS $Ifgd(i ) )))))!)")#)$)')+)2)3)4)5)6)7)8)9);)=)N)P)X)a)b)h)i)j)t)|)))))))ߛ{ll_h"h$DB*^Jphh"h$D5B*^Jphh"hK 5B*phh1h1B*phh1B*phh1hVDB*ph'j.h"h$D5B*Uph'jh"h$D5B*Uph!jh"h$D5B*UphhVD5B*phh"h$D5B*phh15B*ph%))))))))))))))))))))))********** *"*$*+*/*Ÿk\\\h"h$D5B*^Jph'j"!h"h$D5B*Uph'j h"h$D5B*Uph'jj h"h$D5B*Uph!jh"h$D5B*Uphh"h$D5B*phhShK B*^JphhShK 56B*^Jphh"h$DB*^Jphh"hK 56B*^Jph$))))r`<<$Ifgd(iocG & F<<$If^gdh xkd<$$Ifl0&%y0(64 laytGQ)))*r`<<$Ifgd(iocG & F<<$If^gdh xkd$$Ifl0&%y0(64 laytGQ**"***zeS<<$Ifgd(iocG & F<<$If^gdh <<$Ifgd(ixkd!$$Ifl0&%y0(64 laytGQ/*0*1*2*4*6*9*;*O*W*[*a*w*|*~*****************+򷷷wm^^^^hF_eh:6B*^JphhSB*^Jphh"h:B*^Jphh"hB*^Jphhh5B*phhSh5B*^JphhVDB*^Jphh;hB*^Jphh"h$D5B*phhShK B*^JphhYB*^JphhB*^Jphh"h$DB*^Jph****r`<<$Ifgdw [ocG & F<<$If^gdh xkd0"$$Ifl{0&%y0(64 laytGQ***G+zz <<$Ifgd(ixkd"$$Ifl0&%y0(64 laytGQ++++++#+*+.+/+0+1+3+5+6+E+F+G+H+M+Q+R+S+T+U+V+W+_+`+a+b+h+i+j+k+l+m+n+o+p+q+r+s+t+u+v+w+x+y+z+~+++++++hzehACJh5UhiI{&jh' CJU^JaJmHnHuh' jh' Uhh B*ph.th:B*^Jphh"h:B*^JphhF_eh:6B*^Jphhkh:6B*^Jph8G+H+T+U+V+ <<$Ifgd(iekdr#$$Ifl%(0(64 layth V+W+a+b+h+i+ <<$Ifgd(ickd#$$Ifl%(0(64 layth i+j+k+m+n+p+q+s+t+v+w+y+z+$,{vgdzegdh gdxkdz$$$Ifl&0%0(64 layth +++++++++++++++++++++++++++++ , ,,,,,,, ,!,",#,$,%,&,',vhh B*ph.th' hhzehh CJaJhzeh$CJaJjhzehRCJUaJhzehRCJaJhzeCJaJhzehfJbCJhzehGQCJhzeh7CJhzeh-\'CJhzehK CJhzehSCJhzehACJ,$,%,&,',gd$a$gd)i21h:p,. A!"# $Q%6u F"m }JFIF``C      C  E" }!1AQa"q2#BR$3br %&'()*456789:CDEFGHIJSTUVWXYZcdefghijstuvwxyz w!1AQaq"2B #3Rbr $4%&'()*56789:CDEFGHIJSTUVWXYZcdefghijstuvwxyz ?(((((((((((((((((((((((((((((((((((((((((((((((7g _X?S~1*'e_@P~(x-u+]g?U/cҼEibRUű{5|w'_|Ux]i[뺮>1z$U ?@?#_?VP /,?_X:_@Q@"LJOşV4oϥKa&3%塕xb+'9_?}W_o7V/w/[xRR>omdbFӨ}p{PBkcQWC\ux ®1֬hu[PFH1mgCD ee2 i 冏YzNnvv0ZŠ#UUZį|TI̚_|DZtvzGê?f˾u? K/yEO+=rp2x:%xYo h-PKB8K7¿6▷[5t|MKt%x;7PxcG⟄~xTZGÚǤvZ1vZfX1=}e_?;|H=P /,?+Okk@}uj:6c{ki&Tb 1@ yL'wH7< j7>ĻƬ=2ܹ߄_J<3`_PEPEPEPEr?𧭚F|\sq-SHϱT0 j*EuQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQL(RUrI'u9eoxSvL|9ۃN8խ>db HC#Ğ =캆t]3A@[$>VL)Ϯۿp''w/ ^2*j!{-[JNР Uy'G23V;9c_ro=kVxGO~ОjO=+O":df2<ȹ8>eOm~[_h 2-irUFi};_gQm4Eq$h_-ƈ 9'mGZcS/-u7Q..eY2H#)0$A_)xN2+_ߌ_J WWMO7U_@WMO7U@@W?#_?VWƏHaQ@?}W_o+c xŷpgQJb6vJE+En[GWx|x.:7>;볦i{װڳ3վ~*|%dz҃3?s3\i咰˼ǒk?Qi:ԓS$>"4[ȵH*A$7?ᎼYO;ť/]#zѬ3qy$<ׇwr '𴺄˧[@@PŞ!ktjGݎov͵zns|/t-{LO2E|QZiJeV1˵NRHRHEJ{OG|swLu-EOi@ mH1gX.Q 2 _3~GjᏀ|7dLn4[Ųд)YZg@n.tF3[?Z+^ cMCn3\pF[Fxt hvfcgi,0[F `PM': YxRuvw|MƢicV+8bAҼ $GO꾀O$T (/O57O^^C bE$? +]sxg6%k((((((((((((((((((((((((((((((((((((((((((((((((((H'9 rG"YA;TPg#N?m??i_@Q@?çe6o4Grdž4kOѴm>Hh쬱[(#ʑ*Ī>u)񕰨?>7<^٫w'_@P_?5?IeW7}_?5O?7VSƏHa|R5#oz%}EPoM޳tQbֺo~Ϳ?!7>]"9?~[}hu╄[OkVzzҏdV?Y@>(&>xW__>{_kzUTUt+؋(|q߻ n?gz̿웛;y@  (t_ٯ^k_:J(˂po. 1HEqh~:մf̈׾}#ʧ?ܳ尪N'?쪳ɰL'w^!Ʉnt|"Q蕮߄_J<3`_PEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEP%K S?t]X^_¾ 33ⶇes 5Wԯlc2jZ%-oI[_IlaA}&k?Y/mu-'VA$7PHpApAzz?g~E/>4{W\nR"xiF2%Z>.|?i3JQY)S;%M)"u!4> ԭioۊ j WOPj8{]_X.dXq NHԔ/%%Rov)ִؚǍOC?/a+m8 M4.Ml![{[KXV-QDEU@r+k/ڇOKmᘡF)9Y 5cm'qU~(}3P't!#prP㿲ĭfk>:k&% (|Y-Y#UUp0g*O]0x?Ko4ӠBILKbYJInH|-3zWlqIaH&SJPAז|b2/ymk_HKǩ*.Sl;PYkWQxG֔#[BaHxXIX,h ($^mzό_K6g5-Fn0.5[X ȫQ0A>׸(Ÿ5 9(Ԣk d)ԻǬj\u |^Mt4r3-n* 8-||⸶ٰ?"+}/Ŷh?{B_cn֭[HM}^Sj?5R>Յ%Υlt7$*$<_?? |=? ]mn xˑU*Ay"w>{tm%!Ī:}#ʧ?ܰ˜~>|4+G<@庞[8wffS^E|y5Y 4 qei))bȈX(@UD=QQ{7~9ƍ3O?o|OA?4J6RXSHd$^r/#Aj_O:ŕxJK,}f 0IJd,͌( (>R~'c_:hp %wF,,xd ̒*sy+ML{_^xVp73E啶O TPYQ{7wsm;wC%LY,UsQ@VEQEW7??vgy/? [*Z5ǚCjn9ߜE|Q{7"Wo5ET~*?ƨUD=QE}Gj٣^<𝾓s}:"na`h$$If!vh#v#v#vf:V l  0)555f/ 4apytGQ$$If!vh#v#v#vf:V l0)555f4ayt,$$If!vh#v#v#vf:V l0)555f4aytGQtDeCheck2tDeCheck2tDeCheck5$$If!vh#v#v#vf:V l0)555f/ 4aytGQ$$If!vh#v#v#vf:V l0)555f/ / 4aytGQ$$If!vh#v#v#vf:V l0)555f/ 4aytGQtDeCheck2tDeCheck2$$If!vh#v#v#vf:V l0)555f/  / / 4aytGQtDeCheck1tDeCheck2$$If!vh#v#v#vf:V l0)555f/  / / 4aytGQ$$If!vh#v7#v':V l0*575'/ 4ayt,$$If!vh#v7#v#v#v3:V l0*575553/ / 4ayt,$$If!vh#v7#v#v#v3:V l0*575553/ / 4ayt,$$If!vh#v7#v#v#v3:V l0*575553/ / 4ayt,$$If!vh#v7#v#v#v3:V l0*575553/ 4ayt,tDeCheck2tDeCheck2$$If!vh#v7#v #v3:V l0*575 534ayt,tDeCheck2tDeCheck2$$If!vh#v7#v #v3:V l0*575 534ayt,tDeCheck1tDeCheck2$$If!vh#v7#v #v3:V l]0*575 53/ / / /  / / 4apyt,tDeCheck1tDeCheck2$$If!vh#v7#v #v3:V l0*575 534ayt,tDeCheck1DDtDeCheck2tDeCheck1DDtDeCheck2$$If!vh#v7#v #v3:V l0*575 534ayt,tDeCheck1DDtDeCheck2$$If!vh#v7#v #v3:V l0*575 534ayt,tDeCheck1DDtDeCheck2$$If!vh#v7#v #v3:V l`0*575 534ayt,tDeCheck1DDtDeCheck2$$If!vh#v7#v #v3:V l0*575 53/ 4ayt,tDeCheck1DDtDeCheck2$$If!vh#v7#v #v3:V l0*575 534ayt,tDeCheck1DDtDeCheck2$$If!vh#vy#v:V l0(6,5y54aytGQ$$If!vh#vy#v:V l0(65y54aytGQ$$If!vh#vy#v:V l0(6,5y54aytGQtDeCheck1DDtDeCheck2$$If!vh#vy#v:V l0(6,5y54aytGQ$$If!vh#vy#v:V l{0(6,5y54aytGQ$$If!vh#vy#v:V l0(6,5y5/ 4aytGQ$$If!vh#v(:V l0(65(4ayth $$If!vh#v(:V l0(65(4ayth $$If!vh#v#v:V l&0(6554ayth  x6866666662 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p(8HX`~ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@66666_HmH nH sH tH D`D cNormalCJOJQJ_HmH sH tH F@F ! Heading 1$$@&^a$aJDA`D Default Paragraph FontRi@R  Table Normal4 l4a (k (No List 4@4 !Header  9r 4 4 !Footer  9r 0U`0 ! Hyperlink>*B*B^"B c Normal (Web)dd[$\$H2H qx Balloon TextCJOJQJ^JaJB' AB  -Comment ReferenceCJaJ<R<  - Comment TextCJaJ@jQR@  -Comment Subject5\DrD tW1 dxCJOJQJaJmH sH tH jj V Table Grid7:V0jj V Char Char Char Char dxCJOJQJaJmH sH tH >P> 1>m Body Text 2 `^`CJ.). L Page Number>Q> Rk Body Text 3xCJaJFV F ,FollowedHyperlink >*B*phOrRv!R /o#0Unresolved MentionB*phq H H4npRevisionCJOJQJ_HmH sH tH PK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭Vj\{cp/IDg6wZ0s=Dĵw %;r,qlEآyDQ"Q,=c8B,!gxMD&铁M./SAe^QשF½|SˌDإbj|E7C<bʼNpr8fnߧFrI.{1fVԅ$21(t}kJV1/ ÚQL×07#]fVIhcMZ6/Hߏ bW`Gv Ts'BCt!LQ#JxݴyJ] C:= ċ(tRQ;^e1/-/A_Y)^6(p[_&N}njzb\->;nVb*.7p]M|MMM# ud9c47=iV7̪~㦓ødfÕ 5j z'^9J{rJЃ3Ax| FU9…i3Q/B)LʾRPx)04N O'> agYeHj*kblC=hPW!alfpX OAXl:XVZbr Zy4Sw3?WӊhPxzSq]y '$4 X  /@%u6x+ a!:"t#@$;&8'(~( ))/*++', !$(+.0139;>@BEFIJKMNRUY '_jpo `!!"# $&'())***G+V+i+$,',"#%&')*,-/245678:<=?ACDGHLOPQSTVWXZ fv}u6FM]*+;+;BRSc !"!#!3!!!!"""'$XG$G$G$G$G$G$G$G$G$G$G$G$G$G$G$G$G$G$G$G$G$G$G$G$G$G$G$G$G$G$G$G$G$G$G$G$G$G$G$f!t ,R$m }"4@ 0(  B S  ?(    J=A? jPicture 6S"? &l@Check5Check2 _Hlk511388053 _Hlk148691715 p($L($y|k#m#n#p#q#s#t#v#w#x#%$($t x } )0ag k#m#n#p#q#s#t#v#x#%$($3333333333EVot %'`bxu&aNPqp1c@_&jJd !!!!""""H#j#k#m#n#p#q#s#t#v#w#%$($CD ""%%NNppabaa%%&&gg !!!!!!!!!!!!!!""""""""""k#w#x#z#####$#$($ n2M~ړ69G /s,\<eTRf>#x'0:#/-@.LdXf5ǎp>6gP?HC;@2O'A[ n-MLG޿Nw3P~x:!HTWV:Hu]@%fBbGgVr"l>s} a`wbEuF}zW ^`OJQJo( 8^8`OJQJo(^`OJQJ^Jo(o  p^ `OJQJo(  @ ^ `OJQJo( x^x`OJQJo(H^H`OJQJ^Jo(o ^`OJQJo( ^`OJQJo(^`o(.VzV^V`zo(.0^`0o(..  ^ `o(... @ @ ^@ `o( .... `^``o( ..... x`x^x``o( ...... HH^H`o(....... ^`o(........h^`OJQJo(hHh^`OJQJ^Jo(hHohp^p`OJQJo(hHh@ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohP^P`OJQJo(hH88^8`OJQJo(hH``^``OJQJ^Jo(hHo00^0`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHo^`OJQJo(hHpp^p`OJQJo(hH@ @ ^@ `OJQJ^Jo(hHo^`OJQJo(hH L^`LhH. ^`hH. pLp^p`LhH. @ @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.hh^h`OJQJo(hHh8^8`OJQJ^Jo(hHoh^`OJQJo(hHh ^ `OJQJo(hHh ^ `OJQJ^Jo(hHohx^x`OJQJo(hHhH^H`OJQJo(hHh^`OJQJ^Jo(hHoh^`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohp^p`OJQJo(hHh@ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohP^P`OJQJo(hH^`o(. ^`hH. pL^p`LhH. @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PL^P`LhH.hh^h`OJQJo(hH^`OJQJ^Jo(hHo``^``OJQJo(hH00^0`OJQJo(hH^`OJQJ^Jo(hHo^`OJQJo(hH^`OJQJo(hHpp^p`OJQJ^Jo(hHo@ @ ^@ `OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohpp^p`OJQJo(hHh@ @ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohPP^P`OJQJo(hH ^`o(hH.VzV^V`zo(.0^`0o(..  ^ `o(... @ @ ^@ `o( .... `^``o( ..... x`x^x``o( ...... HH^H`o(....... ^`o(........h88^8`OJQJo(hHh^`OJQJ^Jo(hHoh  ^ `OJQJo(hHh  ^ `OJQJo(hHhxx^x`OJQJ^Jo(hHohHH^H`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHoh^`OJQJo(hH808^8`0o(.^`o(. 0 ^ `0o(..^`o(... ^`o( .... `^``o( ..... `^``o( ......   ^ `o(....... ^`o(........^`o(. ^`hH. pL^p`LhH. @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PL^P`LhH.^`o(.VzV^V`zo(.0^`0o(..  ^ `o(... @ @ ^@ `o( .... `^``o( ..... x`x^x``o( ...... HH^H`o(....... ^`o(........ ^`o(hH.VzV^V`zo(.0^`0o(..  ^ `o(... @ @ ^@ `o( .... `^``o( ..... x`x^x``o( ...... HH^H`o(....... ^`o(........h^`OJQJo(hHh^`OJQJ^Jo(hHohp^p`OJQJo(hHh@ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohP^P`OJQJo(hH^`o() ^`hH. pL^p`LhH. @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PL^P`LhH.h^`OJQJo(hHh^`OJQJ^Jo(hHohpp^p`OJQJo(hHh@ @ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohPP^P`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohp^p`OJQJo(hHh@ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohP^P`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohp^p`OJQJo(hHh@ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohP^P`OJQJo(hHhh^h`OJQJo(hH^`OJQJ^Jo(hHo``^``OJQJo(hH00^0`OJQJo(hH^`OJQJ^Jo(hHo^`OJQJo(hH^`OJQJo(hHpp^p`OJQJ^Jo(hHo@ @ ^@ `OJQJo(hHhh^h`o(88^8`o(.p0p^p`0o(..  ^ `o(... xx^x`o( .... `^``o( ..... `^``o( ...... ^`o(....... ^`o(........^`o(. ^`hH. pL^p`LhH. @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PL^P`LhH.hhh^h`OJQJo(hHh88^8`OJQJ^Jo(hHoh^`OJQJo(hHh  ^ `OJQJo(hHh  ^ `OJQJ^Jo(hHohxx^x`OJQJo(hHhHH^H`OJQJo(hHh^`OJQJ^Jo(hHoh^`OJQJo(hH^`o(. ^`hH. pL^p`LhH. @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PL^P`LhH.a`wp>O'AGg;@n.!HT:#/-'%f9GdXf5suF}gP?"l>sV#n-MM~u]eTNw3P         H                                            H                                                                                H                                   eQ(fD3ZpyEg)S;zZp;zfD3DW]pgGs@u491=,|Qt:V z( K : I h  Q z > Y 3QBYVuO3Ta]EgPh:nS\:CYG}#@U >C >0f5 B@WX- WU 4R"["_"E#/o#Z$}$y%&m&'$')'-\'z'S((Q)a)*Y*t*,(,N,Hh,`-o.hV/e 11LJ3]4h56&6`6C7J8u8i9;>;<U<eQ=:>?M?mn]Jnxnxn8pxpxpFqyq~qZ!rus tLtikt.:ulv9'wBwIw x-x]xqx0 yfay(eywy'zNzn{iI{!|t)|N| /}e}e@~R~' Pfq  D3PVKsbK!T - HKVcQ~7 %VDc)i< O4nhJ`Rk'7N8z$9Tl1uWy V1 ^la 5*~BLCSGPI"Rs?S,rZc74hE7L3~ Vq'~^,G.!"y#Eb9Sy-^{X@Le Jm:}}(9Ywkh;"e DKRr ,xLxt#DLTT/w@:RA;bZ#~Y,9PQWu<GW,4/}h< Olv7B=R  q9 !6P.kfOl}?R5h:OWajih0hC$&Y_Ucv(Ob3>w=I FOn83IPZ|f-yk#m#@ '$@@Unknown Farhat Gilani Nicky Gower G.[x Times New Roman5^Symbol3. *Cx Arial5. .[`)Tahoma7. [ @VerdanaC.,*{$ Calibri Light7.*{$ Calibri?= *Cx Courier New;^MWingdingsA$BCambria Math"qhGC 'ڙ' 8I"@I"@ 20Y#Y# 3q@P ?!2! xx<`~ ,JBRU Sickness Absence & Attendance ProcedureCALLEYEN Cadiou, Helent                     Oh+'0 (4 T ` l x'0JBRU Sickness Absence & Attendance Procedure CALLEYEN Normal.dotmCadiou, Helen11Microsoft Office Word@P@dE냳@D2@z_<I"՜.+,D՜.+,D px  %'$University College London Hospital@Y# -JBRU Sickness Absence & Attendance Procedure Title 8@ _PID_HLINKS'A|f_!mailto:jro.sponsorship@ucl.ac.uk  !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklnopqrstuvwxyz{|}~Root Entry F@|<Data m%1Table>}WordDocumentSummaryInformation(DocumentSummaryInformation8CompObjr  F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q