PRICE-CTSI-IOA Pain and Aging Research Pilot Project Proposal
Instructions for Pain and Aging Pilot Proposals Deadline May 31, 2016
Please carefully follow the instructions below and use the forms provided. Proposals that are incomplete or otherwise do not follow instructions will be returned to the investigator without review.
All pages of all items in your proposal must be consecutively numbered, use Arial 11 point font, single spaced, on 8.5 x 11 pages, left justified, with ¾” margins on all sides.
Cover Page
Complete all elements of the cover page:
· Trainees and junior faculty must provide the name, title and UFID of their mentor.
· Include the IRB protocol number and date of approval. If you have not yet obtained IRB approval for your work, enter “NA”.
· Costs: Please use budget worksheet, located at the end of the application, to document costs. Be sure to list funds available for this project from non-CTSI sources. Funding for this pilot project from sources outside of the CTSI will strengthen the application. Written cost estimates for CTSI services must be provided. A list of CTSI services and the appropriate contacts can be found at http://ctsi.ufl.edu/research.
· The completed cover page should be signed and dated by the principal investigator.
Page 2
· Abstract (200 words or less): Provide the rationale for the work, usually in the form of a research question to be answered, and a description of the approach to be taken to answer the question.
· Translational Impact (200 words or less): Describe how the work will improve human health.
· External Funding Plan (200 words or less): Provide a specific plan for obtaining external support. What agency and funding program will be pursued with this pilot data? The clarity and feasibility of the external funding plan will be a strong determinant of funding.
Research Plan
Describe your proposed project in a research plan of no more than five pages. You may submit the same research plan to the IRB and the CTSI. Your plan should include the following sections:
· Specific Aims
· Background/Significance
· Innovation
· Approach – Include preliminary data (as appropriate) as well as clear justification for the number of participants to be enrolled
· References (included in the five page limit)
Project Timeline
Summarize the timeline for achieving the project’s goals. The timeline should be reasonable for the study aims. All projects must be completed within a period of no more than 18 months from notice of award.
Key Personnel
Provide a list of key personnel. For each member of the research team, include name, title, UFID and role on the project. Use additional pages if necessary. NIH biosketches are required for PI, investigator(s) and mentor(s).
Letters of Support
Trainees and Junior Faculty must include letters of support from their mentor(s).
Completing your proposal
Your proposal must include the following items in the order below:
1. Cover Sheet
2. Page 2 – Abstract, Translational Impact, External Funding Plan
3. Research Plan
4. Project Timeline
5. Key Personnel including an NIH biosketch for PI, investigator(s) and mentor(s)
6. Budget Worksheet
7. Letters of support, Cost estimates
Submitting your proposal
Email your complete proposal (including cover sheet and all attachments) as a single PDF to . Applications in response to this RFA are due by 5 p.m. on May 31, 2016. Proposals that do not follow the instructions will not be reviewed. Please email with any questions.
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PRICE-CTSI-IOA Pain and Aging Research Pilot Project Proposal
Cover Sheet for Pain and Aging Research Pilot Project Proposal
Proposal TitlePrincipal Investigator Name
Position/Title
UFID
Co-investigator Name (if applicable)
Position/Title
UFID
Mentor Name (if applicable)
Position/Title
UFID
IRB Protocol Number
IRB Approval Date (mm/dd/yy)
Number of participants to be enrolled
Total cost of proposed work*
Funding available from other sources (e.g., departmental or other support). Please specify amount and source of funds.
Total funds requested from CTSI
*Please use attached Budget Worksheet to document costs.
Principal Investigator Signature
______
Name Date
PRICE-CTSI-IOA Pain and Aging Research Pilot Project Proposal
Page 2
Abstract (200 words or less)
Translational Impact (200 words or less)
External Funding Plan (200 words or less)
PRICE-CTSI-IOA Pain and Aging Research Pilot Project Proposal
Research Plan (no more than 5 pages)
Specific Aims
Background & Significance
Innovation
Approach (including Preliminary Studies)
References
PRICE-CTSI-IOA Pain and Aging Research Pilot Project Proposal
Project Timeline
PRICE-CTSI-IOA Pain and Aging Research Pilot Project Proposal
Key Personnel
Name of Project MemberPosition/Title
UFID
Role on Project
Name of Project Member
Position/Title
UFID
Role on Project
Name of Project Member
Position/Title
UFID
Role on Project
Name of Project Member
Position/Title
UFID
Role on Project
Name of Project Member
Position/Title
UFID
Role on Project
Name of Project Member
Position/Title
UFID
Role on Project
PRICE-CTSI-IOA Pain and Aging Research Pilot Project Proposal
Budget WorksheetP.I. (Last, First):
Title:
Budget Line Item / CTSI Services / Cost (Budget Form/Quote Required) / How will this be funded (i.e. CTSI, Dept.,
etc.) / For Office Use Only
1 / UF CRC Services:
2 / PainCRU Services:
3 / CRC Coordinator Support:
4 / Biorepository:
5 / REDCap:
6 / Regulatory Support:
7 / Informatics:
8 / Biostatistics:
9 / Human Imaging:
10 / Genomics:
11 / Metabolomics Testing:
12
13
14
15
16
17
18
19
20
Total CTSI Services Requested: $
Budget Line Item / Other Services & Equipment: Please Itemize / Cost / How will this be funded (i.e. Pilot funds, Dept.,
etc.) / For Office Use Only
1
2
3
4
5
6
7
8
9
10
Total Non-CTSI Services Requested: $
Total RFA Funding Requested: $
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PRICE-CTSI-IOA Pain and Aging Research Pilot Project Proposal