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Massachusetts General Hospital Biostatistics
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MGH Biostatistics Proposal Intake Form

Is your agreement a subcontract under another organization's award?(Required)
e.g. NIH, NSF, DoD, etc.
MM slash DD slash YYYY
Note: The Biostatistics Director will be notified if the sponsor deadline listed is fifteen (15) business days or fewer from the date this form is submitted.
MM slash DD slash YYYY
MM slash DD slash YYYY
Proposal Type(Required)
Will there be any subcontracts?(Required)
Subcontracts: Is the subrecipient performing Human Subjects Research?(Required)
If yes, is the subrecipient's human research activity exempt?(Required)
Subcontracts: Is the subrecipient receiving or sending any human subjects data or materials as part of the project?(Required)
Subcontracts: Is the subrecipient using vertebrate animals as part of the project?(Required)
Subcontracts: Is the subrecipient using Human Embryonic Stem Cells as part of the project?(Required)
Does the PI have a VA Appointment?(Required)
Is this a Multi-PI proposal?(Required)
Is this project related to COVID-19/coronavirus?(Required)
At this time, will your application have Direct Costs of $500K or more in any one year?(Required)
Key Personnel on the grant (Name and Perfect Effort):(Required)
First and Last Name
Percent Effort
 
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Compliance Questions

Does this project include the use of Human Subjects(Required)
Does this project include a clinical trial?(Required)
Is the protocol oversight at Mass General Brigham IRB office?(Required)
Will non-Mass General Brigham institutions rely on Mass General Brighan IRB for protocol oversight (e.g. if Single IRB policy applies)?(Required)
Does this project include the use of animals?(Required)
If yes, is the protocol oversight at Mass General Brigham IACUC committee?(Required)
Does this project include the use of Biohazard Materials (infectious agent/human materials)?(Required)
Has this study been submitted to Biosafety Committee?(Required)
Does this project contain Radiation/Isotope use?(Required)
Is this project cancer related?(Required)
Does this project include the use of Human Embryonic Stem Cells?(Required)
Will information, materials or equipment be shipped/transmitted (e.g. via email) outside the country?(Required)
Does this project involve activities outside of the U.S. or partnerships with international collaborators? Answer yes if the project involves a foreign component.(Required)
This field is for validation purposes and should be left unchanged.

MGH Biostatistics
50 Staniford Street, Suite 560
Boston, MA 02114

E-mail: biostat@mgh.harvard.edu
Twitter: @mghbiostat

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