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Today M-D-Y
Requester Name* must provide value
Requester Email* must provide value
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What is your primary affiliation with the Conte Center?* must provide value
Project 1 (PI: Van de Water) Project 2 (PI: McAllister) Project 3 (PI: Bauman) Project 4 (PI: Geschwind) Project 5 (PI: Carter) Administrative Core Biostatistics Core Other
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Requester title or academic rank* must provide value
Assistant Professor Associate Professor Professor Postdoctoral Fellow Graduate or Medical Student Undergraduate Student Resident Other
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Project Title* must provide value
What is the main deliverable for this request?* must provide value
Manuscript Grant Proposal Conference Abstract Poster/Presentation Other
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If not grant or manuscript, specify main deliverable
What type of support is needed for this request? (check all that apply)* must provide value
Consultation (guidance only)
Analysis
Writing
Data cleaning
Database management
Training and supervision for analyses I will conduct myself
Other
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Specify other type of support needed for this manuscript, abstract or poster/presentation* must provide value
Indicate current stage of manuscript development/type of help needed* must provide value
Need assistance on Initial draft Need assistance with Revisions Other
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What type of support is needed for this grant proposal? (choose all that apply)* must provide value
Consultation (guidance only)
Analytic plan writing
Preliminary data analysis
Power analysis
Other
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Specify other type of support needed on grant proposal* must provide value
What type of support is needed for this request? (check all that apply)* must provide value
Consultation (guidance only)
Analysis
Manuscript or abstract writing
Analytic plan writing
Preliminary data analysis
Power analysis
Data cleaning
Database management
Training and supervision for analyses I will conduct myself
Other
Choose all that apply
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Is there a firm deadline for this project?* must provide value
Yes
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What is the date of the project deadline?* must provide value
Today M-D-Y
If no firm deadline, what is the desired timeline?* must provide value
1-3 months 4-6 months 7-11 months 1-2 years Other
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Stage of data collection procedures* must provide value
Data collection not started yet Data collection already started and ongoing Data collection completed Other Not applicable - no data collection for this project
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Data storage method* must provide value
REDCap Qualtrics SPSS Excel Access Other
Indicate what software you plan to use for data collection
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Number of variables in database* must provide value
25 or fewer variables 26 - 50 variables 51-100 variables 101 - 200 variables 201 - 350 variables 351 - 500 variables 501 - 750 variables 751 - 1000 variables 1001 - 2000 variables 2001 - 5000 variables More than 5000 variables
Number of database variables (planned or actual)
Number of participants* must provide value
50 or fewer participants 51 - 250 participants 251 - 500 participants 501 - 1,000 participants 1,001 - 5,000 participants 5,001 - 10,000 participants More than 10,000 participants
Total number of participants/study subjects (estimated or actual)
Number of time points/study visits per subject* must provide value
Number of planned timepoints per subject (estimated or actual)
Describe your research project including research questions, analytic aims, and statement of help needed.
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Describe your research project including research questions, analytic aims, and statement of help needed:
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Will someone else be primary contact for this request (other than the person listed above)? * must provide value
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Study Contact Name* must provide value
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