Somewhere in your inbox there is a feasibility questionnaire with a Friday deadline. It asks how many patients matching the indication your site sees in a year, what equipment you have, whether the PI has run studies in the therapeutic area, and how many competing trials you are running.
Most sites answer it in twenty minutes, from memory, in round numbers. That is understandable. It is also the single largest missed opportunity in site business development, because the questionnaire is very often the only evidence a sponsor has about you when deciding where a study’s slots go.
What the sponsor is actually trying to work out
Not whether you are a good site. Whether you will enrol.
Those are different questions, and the industry’s track record on the second one is poor. Phesi’s analysis of 173 cancer trials, covering 11,826 investigator sites and 83,916 patients across 57 countries, found that 27% of activated sites recruited nobody at all. A further 19% enrolled exactly one patient, and those single-patient sites between them accounted for under 3% of total enrolment. Meanwhile the top 16% of sites delivered 54% of the patients.
Read that from the sponsor’s side of the desk. Roughly one site in four that they select, contract, activate and pay for will return nothing. Every question on the feasibility form is an attempt to avoid being wrong about you in that particular way.
Answers that reduce that uncertainty win slots. Answers that leave it intact do not, however impressive the site.
The four answers that change the decision
1. Give a number with a denominator behind it.
“We see approximately 200 patients a year with this indication” is a claim. “Our EMR query for ICD-10 codes X and Y over the trailing 12 months returned 214 patients, of whom 96 were within the age range and 61 had the required prior therapy” is evidence. It is also a smaller number, which feels like a weaker answer and is in fact a much stronger one — because the sponsor has been burned by the larger, rounder version many times, and knows it.
Run the query before you answer. If you cannot run it, say what you can count and how.
2. Answer the eligibility criteria you were not asked about.
Feasibility forms rarely ask about the criterion that will actually sink recruitment — a washout period your patients will not accept, a requirement for treatment-naive patients in a population where almost everyone has been treated, a visit schedule that collides with the reality of your catchment area.
Say it. Flagging the criterion that will limit enrolment is the most credible thing a site can do on a feasibility questionnaire, and it costs you almost nothing: sponsors hear it as operational maturity, not as reluctance. It also occasionally gets the protocol amended.
3. Name the coordinator, not the department.
“We have three experienced coordinators” tells the sponsor nothing about capacity. “Coordinator J.M. will run this study; she currently holds two trials, one of which closes to enrolment in October” tells them everything. If you cannot name the person and account for their load, you do not yet know whether you have capacity — and the questionnaire is a much cheaper place to discover that than month five.
4. Answer the start-up questions before they are asked.
Whether you can rely on a central IRB or must go to local review, when your PI’s CV and GCP training were last refreshed, whether you hold standing contract positions, how quickly you can return a complete regulatory packet. These are start-up facts, and they are usually treated as a later conversation. Volunteering them at feasibility separates you from every other site on the list, because sponsors already know start-up is where their timeline goes: in ICON’s survey of just over 100 principal investigators and senior site staff, 55% said time from site selection to full activation now runs longer than five months, and 39% said it had got worse over the previous two years.
The answer that also wins: no
Declining is not a failure state. ICON’s data shows sites pre-selection decline rates rising from 35% to 47% between 2021 and 2023 — sites are already exercising this more, and the ones doing it deliberately are protecting something valuable.
A site that says “not this protocol, the washout will not work in our population, but send us the next one in this indication” has just given a sponsor accurate information at no cost. A site that accepts, activates and enrols two patients has joined the 27%, and that is remembered longer.
Say no in a way that keeps you on the list: give the reason, keep it specific and operational, and state what you would say yes to.
The part a network handles
Very little of the above is clinical. It is query-running, document currency, capacity accounting and having answers ready before the form arrives — which is exactly the work that gets deprioritised at a busy site, and exactly what a network is for.
The questionnaire itself is yours to complete and submit, and it has to be — the answers are about your patients, your staff and your capacity, and nobody else can stand behind them. What a network changes is what you are starting from. BNZ Research Network holds capability profiles and standing documentation centrally across 120+ US research sites, so when a matched study appears the underlying facts are already assembled and current, and your team is working from them rather than reconstructing them under a Friday deadline. Your site keeps full clinical independence throughout.
Joining the network is free, with no upfront cost — our team reviews every application and responds within 1–2 business days.
Sources: Phesi, “Assessing Single Patient Investigator Sites in Cancer Clinical Trials”, via Applied Clinical Trials (25 January 2023); ICON plc, “ICON survey reveals increasing clinical trial startup delays” (2 December 2025).
