St James's Hospital, Research & Innovation Office
Application Form
*** NOTE: You must fill in this form in full in order for your application to be submitted successfully ***
Do not begin your study until you receive an official approval email from the Research and Innovation Office.
1. SUBMITTED BY / CONTACT FOR THE STUDY
  Full Name:   Email Address:  
  Contact No:   Department: 
  Organisation:   Work Position: 
2. SJH PRINCIPAL INVESTIGATOR / SJH SUPERVISOR
  Principal Investigator Full Name: 
3. CO-INVESTIGATORS / RESEARCH TEAM (add if applicable)
Full Name:Work Position:Organisation:Role on Study:
4. TITLE OF STUDY (max 120 characters)
5.1 PURPOSE OF PROJECT (Choose 1)         To generate new knowledge         Review of current practice/quality improvement
(Do not press the back button in order to prevent losing any data you have entered so far)