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