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E-AHPBA Scientific & Research - Application for the Promotion / Support of a Study
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1. Study Title
(Required.)
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2. Principal Investigator:
(Required.)
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3. Email Address of Principal Investigator:
(Required.)
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4. Is the Principal Investigator an E-AHPBA member?
(Please note that either the Principal Investigator or a senior collaborating member of the team must be an E-AHPBA member)
(Required.)
Yes
No
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5. Leading Study Centre:
(Required.)
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6. Investigator(s):
(Required.)
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7. Please indicate which Investigator(s) are E-AHPBA members:
(Required.)
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8. Hypothesis:
(Required.)
Upload any supporting documents for the hypothesis:
Choose File
No file chosen
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9. Objective(s) / Aims:
(Required.)
Upload any supporting documents for the objective(s) / aims:
Choose File
No file chosen
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10. Methodology:
(Required.)
Upload any supporting documents for the methodology:
Choose File
No file chosen
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11. Duration:
(Required.)
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12. Primary Endpoint:
(Required.)
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13. Secondary Endpoints:
(Required.)
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14. Number of Subjects:
(Required.)
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15. Inclusion Criteria:
(Required.)
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16. Exclusion Criteria:
(Required.)
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17. Data Collection:
(Required.)
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18. Authorship Rules:
(Required.)
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19. Requested Help:
(Required.)
Active: wants help from the Scientific & Research Committee
Passive: just list the study on the E-AHPBA website with contact details
If “Active”, please provide further details on the type of support required:
20. Additional comments or information for the E-AHPBA Scientific & Research Committee:
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Acknowledgement:
(Required.)
I confirm that I have read and understood the E-AHPBA Scientific & Research Endorsement Guidelines available on the E-AHPBA website and agree to adhere to the criteria outlined in this document.
I agree to provide project updates 6 months after endorsement and annually thereafter until completion or publication, and to acknowledge E-AHPBA support in all outputs.
