Request for CRRO Services

Please select the type(s) of your request: *

Regulatory
Recruitment

Please provide a brief description of your request.*

Requestor's Contact Information

Name*

FirstLast

Email*

If you have provided your contact information for previous CRRO consultations, you may skip the next 6 fields.

Degree(s)

Faculty Rank (if applicable)

Requestor's Title

Please provide title or role if "Other"

Phone

If this consultation request is related to work for a specific Boston University course, please indicate the course number:

School

Please enter your school if you selected Other

Department-MED

Department-GSDM

Department-SPH

Department-GMS

Please enter your GMS Department if you selected Other

School/Department--CRC

Please enter your school and department affiliation at CRC

Section-Department of Medicine

Section-Department of Obstetrics & Gynecology

Section-Department of Pediatrics

Section-Department of Radiology

Section-Department of Surgery

PI's NIH eRA Commons ID

The PI's NIH eRA Commons ID is necessary for the CRRO to obtain credit for the consultation to support the CTSI grant. The eRA Commons ID is given by NIH to principal investigators at institutions/organizations to access and share administrative information relating to research grants.

If the PI does not have an eRA Commons ID, he/she must obtain one to ensure proper credit for this consultation. If the PI is a BUMC or CRC investigator, please contact Kate Sokol, 617-353-4365 (ksokol@bu.edu); if the PI is a Boston Medical Center investigator, contact Ellen Jamieson, 617-414-5646 (ellen.jamieson@bmc.org). For more information, see http://ctsi.bu.edu/index.php/contact-us/

Study name/Project title (if applicable)

Study IRB Number (if applicable)

If the project is funded, please indicate sponsor and provide account information in the next three fields.

Sponsor project number

Grants Office (BUMC OSP or BMC Grants Administration)

BUMC or BMC grant/account number

PI Information (if different from above)

Name

FirstLast

Degree

Faculty Rank (if applicable)

Email

Phone

School

Please enter your School if you selected Other

Department-MED

Department-GSDM

Department-SPH

Department GMS

Please enter your GMS Department if you selected Other

School/Department-CRC

Please enter your school and department affiliation at CRC

Section-Department of Medicine

Section-Department of Obstetrics and Gynecology

Section-Department of Pediatrics

Section-Department of Radiology

Section-Department of Surgery

If this is your first time contacting the CRRO, please let us know how you heard about the office.

Request for CRRO Services - Edited 11/1/13

Requestor's Contact Information

PI Information (if different from above)

Clinical Research Resources Office