Research

Research/QI Request Form

Research/QI Request Form

Your request will be submitted to the CEO for review by the Research, Quality Improvement & Guideline (RQIG) Committee.

Date

Type of activity:

Name of research study/quality improvement initiative:

Investigators/Researchers:

Description of the study/QI initiative:

Recruitment timeframe:

Source of funding:

Funding amount:

Ethics approval granted by:

Do you have any Nurse Practitioners as part of your research study team?

How does this research study/QI initiative relate to Nurse Practitioners?

How will research/QI team provide the NPAC with finalized/end of study results?

Do you have a mechanism to report outcome and evaluation results?

If yes, please describe:

Do you intend to publish your findings/results?

Submitted by:

Name

Title

Email adress:

Attachment(s):

Maximum upload size: 516MB

If you are human, leave this field blank.