Today M-D-Y
Project Deadline
* must provide value
Today M-D-Y
Deadline type
* must provide value
Grant
Abstract/Conference
Manuscript
Other
If Other type of deadline, please specify
Principal Investigator First Name
* must provide value
Please enter PI first name only. If you are not the PI on this study, you will be able to enter your name later.
Principal Investigator Last Name
* must provide value
Please enter PI last name only. If you are not the PI on this study, you will be able to enter your name later.
Principal Investigator NETID
* must provide value
Please enter NU NETID. It can be looked up in NU directory with 'Additional details' checked. https://directory.northwestern.edu/search
Principal Investigator e-mail address
* must provide value
Principal Investigator Title
* must provide value
Assistant Professor Associate Professor Professor Fellow Postdoctoral Fellow Graduate Student Instructor Research Assistant Professor Research Associate Professor Research Professor Research Coordinator Resident Other
If "Other", please specify
Institutional Affiliation
* must provide value
If "Other", please specify
Breast Basic Science Cancer Control Cancer Prevention EPT (Early phase therapeutics) GI GU GU - Ashley Ross GynOnc Head & Neck Hem - Leukemia Hem - LPD Hem - MPNs Hem - Transplant Lung Lurie Childrens Neuro Sarcoma Skin Other
If "Other", please specify
Anesthesiology Biochemistry and Molecular Genetics Cell and Molecular Biology Dermatology Emergency Medicine Family and Community Medicine IPHAM Medical Education Medical Social Sciences Medicine Medicine - Allergy and Immunology Medicine - Cardiology Medicine - Endocrinology Medicine - Gastroenterology and Hepatology Medicine - General Internal Medicine and Geriatrics Medicine - Hematology/Oncology Medicine - Hospital Medicine Medicine - Immunotherapy and Autoimmune Diseases Medicine - Infectious Diseases Medicine - Nephrology and Hypertension Medicine - Pulmonary and Critical Care Medicine - Rheumatology Microbiology-Immunology Neurological Surgery Neurology - Ken and Ruth Davee Department Obstetrics and Gynecology Ophthalmology Orthopaedic Surgery Otolaryngology - Head and Neck Surgery Pathology Pediatrics Pediatrics - Academic General Pediatrics and Primary Care Pediatrics - Adolescent Medicine Pediatrics - Allergy and Immunology Pediatrics - Cardiology Pediatrics - Child Abuse Pediatrics Pediatrics - Critical Care Pediatrics - Community-Based Primary Care Pediatrics - Dermatology Pediatrics - Developmental Behavioral Pediatrics Pediatrics - Emergency Medicine Pediatrics - Endocrinology Pediatrics - Gastroenterology, Hepatology, and Nutrition Pediatrics - Genetics, Birth Defects, and Metabolism Pediatrics - Hematology, Oncology, and Stem Cell Transplantation Pediatrics - Hospital-Based Medicine Pediatrics - Infectious Diseases Pediatrics - Kidney Diseases Pediatrics - Neonatology Pediatrics - Neurology Pediatrics - Pulmonary Medicine Pediatrics - Rheumatology Pharmacology Physical Medicine and Rehabilitation Physical Therapy and Human Movement Sciences Physiology Preventive Medicine Preventive Medicine - Behavioral Medicine Preventive Medicine - Biostatistics Preventive Medicine - Epidemiology Preventive Medicine - Cancer Epidemiology and Prevention Preventive Medicine - Nutrition Preventive Medicine - Health and Biomedical Informatics Psychiatry and Behavioral Sciences Radiation Oncology Radiology Surgery Surgery - Breast Surgery Surgery - Cardiac Surgery Surgery - GI & Oncologic Surgery Surgery - Pediatric Surgery - Plastic Surgery Surgery - Thoracic Surgery Surgery - Organ Transplantation Surgery - Trauma & Critical Care Surgery - Vascular Surgery Urology Other
If "Other", please specify
Is the PI a member of the Lurie Cancer Center?
Yes
No
Are you the PI on this project?
* must provide value
Yes
No
Assistant Professor Associate Professor Professor Fellow Postdoctoral Fellow Graduate Student Instructor Research Assistant Professor Research Associate Professor Research Professor Research Coordinator Resident Other
If "Other", please specify
Are you a member of the Lurie Cancer Center?
Yes
No
Contact e-mail address if different from above
It is QDSC policy to communicate only via institutional e-mail addresses (e.g. northwestern.edu, luriechildrens.org, nm.org, etc.) for Feinberg and its affiliates. Please DO NOT enter a non-institutional e-mail address (e.g. gmail.com, yahoo.com). If you are affiliated with Northwestern and enter a non-institutional address, your request may be delayed.
Title of Project
* must provide value
Brief description of project (e.g. objectives, methods, data)
* must provide value
Does this study have an IRB number (starting with STU###)?
Optional
Does this study have a Cancer Center protocol number (starting with NU)?
Optional
Yes
No
Types of Biostatistics support
If Other, please describe
Yes
No
Types of Bioinformatics support
If Other, please describe
Clinical Informatics/Databases
* must provide value
Yes
No
Types of Clinical Informatics support
If Other, please describe
Type of Collaborative Support Requested (Check all that apply)
If "Other", please specify
List required Clinical and NGS data elements
How did you hear about us?
Existing collaboration Word of mouth LCC webpage Internet search NUCATS Presentation Other
If "Other", please specify
Are you currently working with a QDSC member on this project?
Yes
No
Bazzi, Latifa Burdett, Kirsten Chen, Ruohui (Matt) Chmiel, Joan Helenowski, Irene Kocherginsky, Masha Lancki, Nicola Ramesh Kumar, Sai Kaushik Shankar Sun, Zequn Zhang, Hui Antonio, Daniel -------------------------------------- Bartom, Elizabeth Patel, Priyam Schipma, Matthew Wray, Brian --------------------------------------- Gurley, Michael Katam, Neelima Salvo, Giorgio Di --------------------------------------- Not Eligible
Have you worked with the QDSC before?
Yes
No
Antonio, Daniel Bazzi, Latifa Burdett, Kirsten Chen, Ruohui (Matt) Chmiel, Joan Kocherginsky, Masha Liu, Alex Ma, Anna Ramesh Kumar, Sai Kaushik Shankar Sun, Zequn Zhang, Hui Bartom, Elizabeth Patel, Priyam Schipma, Matthew Wray, Brian Gurley, Michael Katam, Neelima Salvo, Giorgio Di
User submission
EDW Import
Clinical trial