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
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