If you want to request help with a database for administrative purposes only you are in the wrong place. Please go to Pediatric IS website http://infoscope.mcw.edu/Pediatrics/IS/AboutUS/Database-Development-and-Project-Services.htm. For assistance filling out this form, please contact a member of Quantitative Health Services at (414)955-7675.
First Name: Last Name: Title:
Are you a CTSI member? Yes No
Are you a member of the MCW Cancer Center? Yes No
P.I. first name*: P.I. last name:
Is your P.I. a CTSI member? Yes No
Is your P.I. a member of the MCW Cancer Center? Yes No
*MCW Faculty must be named as Principal Investigators.
Title of Research Project:
Is this a cancer related project? Yes No
Do you have IRB approval? Yes No
QHS Services Requested
Collaboration on an IRB proposal
Scannable form development*
Collaboration on a grant proposal
Data collection tool development*