Department of Biostatistics - Consulting Request

Consulting Request Form

Please complete the following form and somebody will contact you within a week. Items in bold are required. If your project has co-investigators, please list their name and affiliation in the description block. If you do not receive a confirmation e-mail within 24 hours of submitting your request, please resubmit.

Name:
Email:
Phone #:
Your Location:
	If location is "other", please list here:
Department:
Department Chair:
Status:
Project Title:
Description: Provide a brief (1 to 2 sentence) description of your project.
Help Needed: Please indicate what type of statistical help is needed (i.e. design, analysis, graphics, etc).
Collected Data:
Consulting Purpose:	Renewal of an Existing Grant Future Grant Application New Manuscript Revised Manuscript Technical Report Thesis or Dissertation other
Advisor:	If the consult is for a student, who is the main advisor?
Principal Investigator:	If this project is not a thesis, then who is the principal investigator?
Attach CV/Résumé:	Curriculum vitae or résumé is required before a project is accepted.