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MAPMG Research Interest Form
Requestor Information
*
1.
First Name
(Required.)
*
2.
Last Name
(Required.)
*
3.
Email Address
(@kp.org)
(Required.)
*
4.
Department
(Required.)
*
5.
Position
(Required.)
Resident
Shareholder Track Physician
Shareholder Physician
Non-Shareholder or Hourly Physician
MAPMG administrative staff
Non-MAPMG; Kaiser Foundation Health Plan
Other (please specify)
*
6.
What type of project or assistance are you interested in?
(Required.)
I am seeking
approval
for an already prepared abstract or manuscript.
I need assistance preparing an
abstract
(poster or talk) for a medical/scientific conference.
I need assistance preparing a
manuscript
for submission to a medical/scientific journal.
I need assistance with
other writing services
(resume, lit review, grant writing, etc.).
I want to express an
interest in conducting research
or
propose a specific research project
or
submit an IRB application
.
I am interested in learning more about
clinical trials research
.
I would like assistance
determining if my project is considered research
.
I would like to apply for research
grant funding
(NIH, foundation, etc.).
I would like to request approval or support for an
external academic degree program
.
I would like to sign up for a
Permanente Pathways
experience.
I have a
general question
for the research team.
