MGH Biostatistics Consulting Request - Additional Information Please complete this form to provide additional information about your biostatistics consultation request. "*" indicates required fields Name* First Last Email* Project title* Grant Status of ProjectIs this project grant-related?This project is a: Pilot study for a grant Grant application Funded grant Is this project a training grant? Yes No Specify a grant type (select all that apply) Federal grant (NIH, CDC, FDA, DOD, NASA, VA) Harvard Catalyst Pilot grant Other type of grant (foundation, industry, private, etc.) Specific AimsPlease provide specific aims if available, or upload a file below.Upload File: Specific AimsMax. file size: 128 MB.Additional InformationDo you need a biostatistician to discuss study design and/or perform sample size/power calculations? Yes No Please describe the primary hypothesis of your project.If available, please provide publications or preliminary results that relate to the design of your study.Paste links here. Upload files below.File upload: publications or preliminary resultsFile upload: publications or preliminary resultsMax. file size: 128 MB.Do you need a biostatistician to analyze your data? Yes No Do you have funding to support the cost of data analysis?Please note: MGH Biostatistics offers fee-for-service support for data analysis; we are not able to analyze data free of charge. Yes No What is the Institutional Review Board (IRB) status of this project? Approved Submitted/Pending Preparing IRB application for submission Not applicable IRB approved details IRB protocol PI name (if not requestor) IRB protocol number IRB protocol title Please describe the primary and secondary objectives of the data analysis to be performed.Are you seeking a biostatistician or data coordinating center for long-term support for collaboration on grants and/or ongoing research projects? Yes No Please describe your current and ongoing projects and statistical support needed.NameThis field is for validation purposes and should be left unchanged.