Contact Us

Name of Chief/Principal Investigator (CI/PI)

Position

Organisation

Department

Email

Is the CI/PI the main point of contact?

Yes

No

If no, please give Name and Email details of the main point of contact here:

Sponsoring institution (please provide details of the sponsor)

Have you had support/contact with the Research Support Service for developing this study?

Yes

No

If yes, please give details here

Study/Trial title

Brief outline of the research question

Brief outline of research design (Participants, intervention, control, outcomes, methodology etc.)

Likely duration of the study

Likely start date of the study

Please tick all that are relevant to your study/trial

Please tick all required LinCTU support you may need

Study design and support with developing the funding application

Assistance with protocol development and review prior to study start

Support with completion of ethics and regulatory forms

Trial coordination (e.g. management of trial and site files, site monitoring)

Database build

Database management and data monitoring of data completeness

Randomisation

Statistics

Health economics

Please state any other support you need that is not listed above:

Funder

Call/Programme

Submission deadline (if known)

Other sources of financial support (e.g. drug/device supply, equipment provision, commercial support, etc.)

Please use the box below if you wish to add further comments or information.

Please attach any appropriate supporting documentation here

Maximum file size: 52.22MB