University of SouthFlorida
Phone: (813) 974-3055
(813) 974-6678
Fax: (813)974-4719
Email: / Biostatistics & EpidemiologyCenter for Collaborative Research
Service Request Form / Date Form Filed:
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Contact Information
  1. Name of Requestor:

First Last
  1. Name of Contact:

First Last
  1. Are you affiliated with USF?
/
  1. If USF affiliated, you are a

Yes No / faculty staff graduate student/resident
  1. College
/
  1. Department

  1. If not USF affiliated, your professional affiliation:

  1. Mailing Address:

  1. Telephone:
/ Fax: / Email:
Project Information
  1. Field of research of this project:

  1. Project is Funded Not Funded

  1. Project is Completed, ready for analysis In planning stage
Ongoing, expected date of completion(mm/yyyy)/
  1. Brief description of your scientific question and study design:

  1. Type of service(s) you are requesting:
Formulating research question;
Choosing study design (e.g. sample size and or power calculation);
Choosing data collection methods;
Data entry and processing;
Statistical data analysis
Interpretation and/or presentation of results, manuscript preparation
  1. Staff initially contacted:

Center Policy

At CCR we strive to provide biostatistical collaboration and support that are increasingly critical to the competitiveness and success of clinical and basic research at USF. In line with the standard practice in major research institutions, the following policy will guide the research collaboration and support the CCR provides. While the policy applies to both funded and unfunded research, the investigator is welcome to work with the CCR if any special arrangement is necessary.

  • Grant Proposals. Grant proposals developed with collaboration and support from the CCR usually shall include a biostatistician as a co-investigator;
  • Publications.The biostatistician who developed data analysis plan and conducted data analysis shall be a co-author of any publications or presentation resulted from such collaboration;
  • Fee. Collaboration and support provided by the CCR is fee based; Payment covers the cost of the center's operation and does not substitute for co-authorship or other status of collaboration;

With partial funding from the USF's HealthScienceCenter, CCR aims to become a resource center with future funding primarily generated from collaborative research grants and fees covering supportive activity. Self-generated funding is necessary to cover faculty/staff salary, student support, and operation expenditure. CCR's primary mission is to promote research that will lead to publications and grant proposals. CCR also supports other activities when resource is available.

Declaration

Do not forget to sign and date your application, otherwise it will not be fully valid and may therefore have to be sent back to you before the application can be considered.

I certify that the information I provide on this form is complete and accurate. Furthermore, I will take financial responsibility for my requested service and co-authorship as outline above.

SignatureDate