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Bowdoin St Research Collaboration Survey

Thank you for your interest in collaborating with Bowdoin St. on research that is important to our patients and community. To ensure transparency in research partnerships, we have implemented a research intake process to help support the success of your research project.

Please provide the information requested below.

An option for rapid review (1 week max turnaround) is available for investigators seeking letters of support, or for research projects that do not require Bowdoin research resources (see below).

For all other projects there will be a *maximum 2 week* turnaround timeframe for us to conduct our internal review.

If you have any questions, please reach out to tsalant@bidmc.harvard.edu

Your name

* must provide value

Your email address

* must provide value

Primary contact name (if different from the person completing this form)

Primary contact email address (if different from person completing this form)

What is the title of the research project?

* must provide value

Are you seeking a letter of support for grant submission purposes?

* must provide value

Yes

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Please list the PI and co-Investigators

* must provide value

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In 3-5 sentences, describe the main aims of the research project, including the population of focus and the types of data to be collected.

* must provide value

Expand

Where are you in the research process (i.e. preparing for funding submission, funded, preparing to submit to IRB, actively enrolling participants)? Please list any important deadlines.

* must provide value

Expand

How do you plan to recruit Bowdoin St. patients? (select all that apply)

* must provide value

MyChart messages

Recruitment flyers and posters

Direct phone calls to patients

Tabling at Bowdoin St or community events

Other

Other recruitment strategy (please describe)

Please list important risks to those who might participate in this research study.

* must provide value

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Please list important benefits to Bowdoin St. Health Center, to the community that we serve, and to those who might participate in the study.

* must provide value

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Will study materials be available in different languages? If so, please list these.

* must provide value

To what extent will clinical workflows be affected by the research activities? If research activities co-occur with clinical visits, what are your plans to educate and engage Bowdoin staff in the research activities?

* must provide value

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Which of the following Bowdoin St research resources do you plan to utilize (select all that apply)?

* must provide value

Community Advisory Board meetings

Bowdoin co-Investigator

Bowdoin Research Coordinator

Room/space use (e.g. for patient consent, interviews, or clinical testing)

Research specimen (blood, urine) collection

Specimen lab processing

Other

None of the above

Other Bowdoin St. resource

How do you plan to share the findings or progress of your research with the health center and the community?

* must provide value

Expand

Please upload any study materials that you would like us to review or that would help us better understand the project (e.g. project summary, IRB submission, recruitment materials). Please upload as a single file.

Upload file

You have selected an option that triggers this survey to end right now.

To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.