HR Compliance Form

HR Compliance Submission Report

  • If you have compliance related questions, requests (for data privacy), or complaints please fill out the information below. Please be sure to provide complete information or we may not be able to properly address your compliance inquiry, request or complaint. Please ONLY USE THIS FORM to submit a compliance inquiry, request or complaint as we may not be able to completely address your compliance inquiry, request or complaint in a timely fashion if you use alternative means of communication. Please note that Clinipace will not retaliate against you if you submit a compliance concern or complaint in good faith. If you wish to remain anonymous, select the appropriate button below. Please note that this submission report is for compliance concerns only (i.e. anti-corruption, privacy, etc.) and is not to be used for any other purpose.

    By submitting this form, you understand and agree that this form may be shared with appropriate members of the Clinipace team, including the Clinipace Compliance Officer, the CLINIPACE Global Data Privacy Officer and/or other applicable members of the Clinipace team and, if appropriate, to applicable government agencies. This report shall be subject to the Clinipace Privacy Policy, located at https://www.clinipace.com/privacy-statement/. If you choose to submit your contact information with this form, you will be notified of the outcome of any investigation if permitted by applicable laws and/or regulatory agencies.

  • My Contact Information

    * Please note that specific data privacy requests/complaints concerning your personal data cannot be submitted anonymously.


  • For Privacy related inquiries, requests, concerns or complaints, please indicate your relationship to Clinipace, as appropriate, below:
  • *If you are a clinical trial subject participating in a Clinipace related clinical trial please reach out to the institutional/investigator contact indicated on your clinical subject Informed consent form for all privacy related inquiries and/or complaints
  • Compliance Questions

  • (please describe)
  • Compliance Requests – Data Privacy Only

  • (please describe)
  • *Please note that, unless prohibited by law, CLINIPACE reserves the right to charge a reasonable fee to cover the cost of providing paper copies of the data you are requesting such as printer and shipping fees.
  • *Please note that if we are required to retain the personal data in order to comply with legal requirements we may not be able to fullfill your request.
  • Compliance Complaints

  • (please describe)
  • If the complaint is related to data privacy, please provide a description of the specific data that is the subject of your concern (i.e. your name, cv, email adress, banking information etc…).
  • If you selected NO, PLEASE REFRAIN from submitting any reports to any third parties / agencies until the Clinipace Compliance team has had a chance to review / investigate the concern.
  • If you selected NO, PLEASE REFRAIN from submitting any reports to any third parties / agencies until the Clinipace Compliance team has had a chance to review / investigate the concern. For Privacy complaints, under law you may reach out to our independent third party dispute resolution body and/or the DPA if we have not contacted you regarding your privacy related compliant within forty five (45) days from our receipt of your compliant. Please refer to your applicable information notice (located at https://www.clinipace.com/privacy-statement) for more information regarding the privacy complaint process.