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Office for Clinical Research Advancement
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About OCRA
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Biostatistics
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CRTU Study Assessment Form
*
Principal Investigator
*
Email
*
Best Contact Number
*
Protocol Title
Funding Source
(if applicable please include amount of award and sponsoring organization)
*
Proposed # of Subjects to Enroll
*
Vulnerable Population
YES
No
Uncertain
FSU IRB STATUS
Not Submitted
Under Review
Approved
Are you working with another IRB?
YES
No
If yes, which IRB?
*
CRTU Services you would like to discuss using
Regular Hours (0730-1700)
Expanded Hours (0630-1830)
CRTU Laptop use (on-site)
Interview Room Use
Procedure/Exam Room Use
Document Retention
Study coordination services
Vital Signs Measurement
Body Composition Measurements
Biostatistical Consultant
Phlebotomy services
Room use only (subject to CRTU nurse approval and oversight)
CRTU Phlebotomist
CRTU Purchased Supplies
PI Provided Supplies
IV Catheter Placement
Specimen Collection/Handling
Blood
Urine
Stool
Saliva
Other
Please specify
Sample Processing
Centrifugation
Refrigerated Centrifugation
Aliquot
Ambient Storage
Fridge (5°C) Storage
Freezer (-20°C) Storage
Freezer (-80°C) Storage
Estimated Duration of Storage Needed
Nutritional Services
Food Scale
Refrigerated Foods/Drinks
Frozen Foods
Wet Ice
Other
Please describe "Other"
Additional Information or Study Needs not covered above:
Requested Attachments (Study Protocol, Informed Consent, Recruitment Materials)
Holding the Ctrl/Command key while selecting files will allow you to upload multiple at once.
Submit
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