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IIT PDU project request

Please complete this form and someone from the Investigator Initiated Protocol Development Unit will contact you as soon as possible.

For more information, contact markey.IITPDU@uky.edu.

Contact Information

 

Email address of the person completing form / Contact person:* 

 

  

Please check this email address. 

 

Phone number of the person completing form / Contact person:* 

 

  

 

 

Project Title:* 

 

  

 

Name of Principal Investigator:* 

 

  

 

PI Email:* 

 

  

Please check this email address. 

 

Department:* 

 

   

 

Project Information

 


Does this project already have IRB approval?* 

 

  
                                         

 


What is the purpose of the project and what types of protocol development support do you need?*  (Please provide all that apply.)

 

 








        
 

If applying for a grant, please indicate grant deadline (if any):

 

   [None] Select a Date Delete the Date 

 


Is this project cancer related?* 

 

  
        

 
Are you a cancer center member?* 

 

 
                                        
 


If yes, which program are you in?

 

 




                    
 


Is your concept or protocol already developed?
*
  If yes, please click here to email separately. Include Project Title and name of PI.

 

  
                                        

 

Please supply additional comments, project description or other information, if any