subject_line
Research Design & Biostatistics (RDB) Core
Date (Ex. 01/01/2011):
*
Name of Person Requesting Service:
*
Principal Investigator:
*
Phone: (Ex. 123-456-7890):
*
E-mail Address:
*
New Study?
*
Yes
No
Ongoing Study:
*
Yes
No
Pilot Study?
*
Yes
No
Please List Funding Source:
Grant Number:
Position (Please select all that apply):
*
Principal Investigator
Faculty
Visiting Scholar
Research Scholar
Research Associate
Postdoctoral Fellow
Research Staff
Teaching Associate
Clinical Assistant
Student
If Student, (Please select degree program):
Doctor of Medicine (MD) Program
Doctor of Philosophy (PhD) in Biomedical Sciences Program
Master of Science in Biomedical Research (MSBR) Program
Master of Science in Biomedical Technology (MSBT) Program
Master of Public Health (MPH) Program
Master of Science in Clinical Research (MSCR) Program
MD/PhD in Biomedical Sciences Program
MD/MPH Dual Degree Program
MD/MSCR Program
MSCR/PhD Program
Resident
Please select an Academic Department and/or Center & Institute:
Academic Department:
Community Health & Preventive Medicine
Family Medicine
Medical Education
Internal Medicine
Microbiology, Biochemistry, & Immunology
Neurobiology
Obstetrics & Gynecology
Pathology & Anatomy
Pediatrics
Pharmacology & Toxicology
Physiology
Psychiatry & Behavioral Sciences
Surgery
Research Centers & Institutes:
Georgia Clinical & Translational Science Institutes (Georgia CTSA)
Cardiovascular Research Institute (CVRI)
Center of Excellence on Health Disparities (CEHD)
Center for Laboratory Animals Resources (CLAR)
Clinical Research Center (CRC)
Center for Translational Research in Health Disparities
Jackson Heart Study Vanguard Center
Morehouse/Emory Cardiovascular Center for Health Equity (AHA MECA)
National Center for Primary Care (NCPC)
Neuroscience Institute (NI)
Office of Translational Technologies
Prevention Research Center (PRC)
RCMI Center of Excellence in Clinical and Translational Research (R-CENTER)
Research Centers in Minority Institution Program (RCMI)
Satcher Health Leadership Institute (SHLI)
Transdisciplinary Collaborative Research Center on Health Disparities (TCC)
Project Title:
*
Services Requested (Select all that apply):
Assess to Jackson Heart Study Data (Please upload the proposed project summary below)**
Cost Benefit Analysis
Data Collection Form Development
Database Development (Contact the BIU Core htyree@msm.edu)
Manuscript Preparation
Manuscript Review
Presentation Review
Proposal Development (Please provide additional information below)
Sample Size and Power Calculations
Statistical Analysis
Statistical Analytical Planning
Study Design Planning
Other:
Other:
Proposal Development Information:
Funding Agency:
Proposal Due Date:
RFA/FOA Number:
**
Jackson Heart Study Project Proposal ONLY
: Please upload your proposed project summary for review.