Application form to contract with UZ Leuven

Applicant details
Are you a UZ Leuven employee?
Betrokken arts/dienstverlener

Contactpersoon in UZ Leuven voor verdere afstemming rond contract en ondertekening.

Contactpersoon in UZ Leuven voor verdere afstemming rond contract en ondertekening.

Tweede betrokken arts/dienstverlener

Contactpersoon in UZ Leuven voor verdere afstemming rond contract en ondertekening.

Contactpersoon in UZ Leuven voor verdere afstemming rond contract en ondertekening.

Derde betrokken arts/dienstverlener

Contactpersoon in UZ Leuven voor verdere afstemming rond contract en ondertekening.

Contactpersoon in UZ Leuven voor verdere afstemming rond contract en ondertekening.

Vierde betrokken arts/dienstverlener

Contactpersoon in UZ Leuven voor verdere afstemming rond contract en ondertekening.

Contactpersoon in UZ Leuven voor verdere afstemming rond contract en ondertekening.

Contractpartij
Tweede contractpartij
Derde contractpartij
Derde contractpartij
Contract proposition details
Contract language
Contract template
Type of contract
Outside the framework of a (future) clinical study at UZ Leuven. (Confidentiality agreement)
Speaker assignment as a UZ Leuven employee
Manner in which event is organised
Will there be pictures, audio or video recordings during the execution of the assignment?
Target audience
Sponsoring of or educational grant for a scientific event organised by and with costs borne by UZ Leuven
Manner in which event is organised

E.g. presence of X number of representatives, installation of an information booth amounting to X m², mention of the company's logo on ...

The total costs consist of the organisation of the event with breakdown into venue hire, catering (if < 6 hrs scientific activity max. amount €23/hr.; if ≥ 6hrs scientific activity max. amount €135/day; max. amounts (incl. drinks) lunch € 45, dinner € 90, breaks € 23), speakers' fees, printing etc. compliant with the legislation of section 10 of the Law on Medication and the Mdeon-legislation and that the necessary supporting documents in this context will be filed by the department for a period of 10 years.

Sponsoring of or educational grant for the participation of a UZ Leuven employee in an external scientific event
Training and workshops for healthcare practitioners or with the involvement of UZ Leuven patients
Involvement of patients
Location of the training
Target audience
(Scientific) grant with costs borne by UZ Leuven related to a scientific research project or a care or quality improvement project

Such as may be added to the contract.

Is there a quid pro quo provided for the firm?

E.g. reporting

Confidentiality agreements if related to the operations of or cooperation with UZ Leuven
Who will share confidential information?
Cooperation agreements with other healthcare facilities
Extra muros assignment in another healthcare facility
Performances by UZ Leuven on behalf of the government/NIHDI/FOD/...
Last edit: 18 September 2023