CCORDA online request

          Date:

  Name of Principal Investigator:
  Appointment type: Faculty
Staff
Resident/Fellow
Post-Doc
Grad/Medical Student
Other

  If student/resident/fellow
Name of Faculty Mentor:
  Department/Division:
  E-Mail:
  Telephone:
  Indicate important time deadlines (abstracts, etc.):

  Reason for deadline: grant submission
abstract
presentation
manuscript
other

  IRB approval: yes
no
pending

  If "yes", IRB approval number:


  Check X if the human biological material(s) or derivative(s) to be evaluated involve: oocytes
embryos
fetal tissue
human embryonic stem cells
any cell derived by, or invloving cloning or somatic cell nuclear transfer
None of the above

  If you checked X to any of the above materials or derivates, has the study been approved by Embryonic Steam Cell Research Oversight Committee (ESCRO-C)? yes
no



Brief description of the project:
  1) Project title:

  2) Cancer related: yes
no

  3) Type of support requested: Research design/development
Database development
Data acquisition and management
Clinical research ethics
Data analysis/statistical support
Research with underserved populations
Community-Based Participatory Research

  4) Brief goals and description of the project


 

Important things to bring to the first meeting:

  • Your research hypothesis.
  • Your data (if available -- on a disk or other portable media if electronic version is available). A printed example of your data is also useful for discussion. Please make sure you have IRB approval. Personal identifying information should be removed.
  • Relevant papers from the literature.
  • Your written research proposal or draft of your manuscript if available.

 



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