CBAI Project Registration

Project Registration Form

Date: Nov 1, 2014

Date of Initial Contact (if other than today's date):

Email Address of Person Completing Form:

Project Title:

Primary Investigator: First Name:      Last Name:      Suffix:

PI Email:

Department:

Co Investigators:

Is This In The Project/Study Development Phase? (has not been submitted and/or received Institutional Approvals)
Yes     No

Are you applying for a Grant?:
Yes      No

Grant Deadline Date:

Please indicate if you are submitting to one of the following Peer-Reviewed Funding Organizations:
if other:

Human Subject Certification (including Exempt studies):
IRB Approval # Date

Vertebrate Animals:
IACUC Approval # Date

Cancer or Cancer Related:
Yes     No

Do You Need Statistical Analysis?:
Yes     No

Do You Need Data Management?:
Yes     No

Center Affiliation:(if applicable)Indicate All that Apply:
Cardiovascular Research Institute (CVRI)
Center for American Indian Community Health (CAICH)
Center for Child Health and Development
Center for Childrens Healthy Lifestyles and Nutrition
Center for Health Behavior Neuroscience
Center for Healthcare Informatics
Center for TeleMedicine and TeleHealth
Center for Viral Oncology
Center on Aging
Frontiers: The Heartland Institute for Clinical and Translational Research
Hoglund Brain Imaging Center
Institute for Advancing Medical Innovation
Institute for Molecular and Outcomes Medicine
Institute for Neurological Disorders
Institute for Reproductive Health and Regenerative Medicine
Institute of Community and Public Health
Integrative Medicine
Internal Medicine Research Office (IMRO)
IM-OSARM
KCUMB-ORSP
K-INBRE
Kidney Institute
KU Alzheimers Disease Center
KU Clinical Research Center
KU Diabetes Institute
Liver Center
Office of Research-Wichita
Radiology
Smith Intellectual and Developmental Disabilities Research Center
The University of Kansas Cancer Center


Please select any Department of Biostatistics Faculty currently associated with this project:

Dr. Michael Brimacombe
Dr. Prabhakar Chalise
Dr. Francisco Diaz
Dr. Frank Dong
Dr. Brooke Fridley
Dr. Byron Gajewski
Dr. Jianghua He
Dr. John Keighley
Dr. Devin Koestler
Dr. Jonathan Mahnken
Dr. Matthew Mayo
Dr. Milind Phadnis
Dr. Vincent Staggs
Dr. Philip Twumasi-Ankrah
Dr. Jo Wick
Dr. Henry Yeh


Additional Comments, Description, or Other Information:



Project Submission may take a few moments. Please click the submission button only once.