Biostatistics Consultation Request - Massachusetts General Hospital Biostatistics

Contact Information

Name*

First Last

Email*

Phone

Are you the principal or lead investigator for this project?*

If you are not the principal or lead investigator (e.g. you are a fellow, resident, student or coordinator), please provide PI information:

PI Name

PI Email

Degrees (select all that apply)*

Rank/Position*

Primary Institution*

MGH Department/Division*

Other Department/Division

Please specify:

Requested Biostatistician (optional)

Project title*

Disease Area*

Other Disease Area

Please specify:

What type of project does this consultation involve? (select all that apply)*

Reason for consultation*

In 2-3 sentences, please describe your project and why you are requesting a consultation.

Anticipated timeline of requested service (if any)

Comments

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