Project Registration Form

Date: Nov 21, 2024

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:
NA NIH Agency for Healthcare Research and Quality (AHRQ) American Cancer Society (ACS) American Foundation for AIDS Research (AFAR) American Institute for Cancer Research (AICR) Center for Disease Control and Prevention (CDC) Central Office of the Veterans Administration (VA) Environmental Protection Agency (EPA) Food and Drug Administration (FDA) Howard Hughes Foundation Leukemia and Lymphoma Society Multiple Myeloma Research Foundation National Institute for Occupational Safety and Health (NIOSH) National Science Foundation (NSF) Prevent Cancer Foundation Susan G. Komen for the Cure University of California-Wide Breast Cancer Research Program US Army (DOD) Florida Biomedical Research Program Other 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 support?:
Yes     No

Do You Need Data Management?:
Yes     No

Do You Need Genomics / Bioinformatics support?:
Yes     No

Center Affiliations & Core Support:(if applicable)Indicate All that Apply:
Cardiovascular Medicine - CVM
Cardiothoracic Surgery Residency– CTS
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
Department of Surgery
Frontiers: The Heartland Institute for Clinical and Translational Research
Hematologic Malignancies and Cellular Therapeutics
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
IM-OSARM
KCUMB-ORSP
Kansas Institute for Precision Medicine
K-INBRE
Kidney Institute
KU Alzheimers Disease Research Center
KU Clinical Research Center
KU Diabetes Institute
Office of Research-Wichita
Liver Center
Radiology
Smith Intellectual and Developmental Disabilities Research Center
The University of Kansas Cancer Center


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

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