Quantitative Health Sciences

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Research Project Registration Form

For assistance filling out this form, please contact a member of Quantitative Health Services at (414)955-7675.

Project Information

Project Title: 

Project IRB Status: 

Brief Summary of the project: 

When is the estimated start date of the project?: 

Investigator Information

Principal investigator first name*: 

Principal investigator last name*: 

*Fellows, Residents and Medical Students can be named as Co-Investigators, but MCW Faculty must be named as Principal Investigators.

Department/Division:

Contact first name: 

Contact last name: 

email address:

QHS Services Requested

Biostatistical consultation

Study design

Biostatistical design

Survey development

Biostatistical analysis

Database development*

Collaboration on an IRB proposal

Scannable form development*

Collaboration on a grant proposal

Data collection tool development*


*If database, scannable form, or data collection development is needed, please complete the following:

The database will be used for: Clinical researchAdministrative

The data will be entered: Data entered directly in a database Other

What is the estimated start date of data collection? 

Is there existing data that will be used in the database? Yes** No

**If yes, how is existing data stored? Excel Word Access Paper Form Other

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Page Updated 12/31/2013