NIHR Research Design Servicenorth West (RDS NW) - Advice and Support Request Form

NIHR Research Design ServiceNorth West (RDS NW) - advice and support request form

Please complete all of the information below where applicable.Providing as much information as you possible will allow us to approve your advice request as quickly as possible and will help facilitate the advice process.

For possible answers marked **, please see last page for definitions.

If you have any problems filling in the form then please try the PDF version of this form here. Alternatively please email us at .

Data Protection, Privacy and terms of service

Before sending this advice request form, please read our Charter, Working Agreement and Terms and Conditions found at submitting this advice request form you agree to the contents within these documents and the terms of our service.

The details you provide on this form will be handled and processedin-line with our data protection and privacy statement. This can found at

If you are unable to view any of these documents please contact us using the contact details at the end of this form.

Information about you

TitlePlease SelectProf.Dr.Mr.Mrs.Miss.Ms.OtherFirst nameSurname

Organisation

ProfessionPlease SelectAcademicAmbulanceClinical Engineering and physical sciencesClinical ScientistsDentalDieteticsManagementMedical ProfessionalMidwiferyNursingOccupational TherapyPhysiological SciencesPhysiotherapyRadiographySpeech and Language TherapyOtherIf ‘Other’ please specify

Please classify your profession Please SelectClinicalClinical academicAcademicNHS ManagerOther**If ‘Other’ please specify

EmailRepeat email

Telephone

About your role on the project

Please select where applicable Please SelectChief InvestigatorCo-collaboratorResearcherResearch and Development DepartmentAdministratorOther

About the project team (not including the chief investigator)

Do any of the research team members fit into the following roles (please fill in all that are relevant)?**

Clinical Clinical academic Academic NHS manager If ‘Other’ please specify

Role of chief investigator

Please select if not yourselfPlease SelectClinicalClinical academicAcademicNHS ManagerOtherUnknown**If‘Other’ please specify

Your research proposal and intended funding stream

Title of your project (you can enter a working title here or topic area if not known)

Planned study design and methodology (if known)

For which funding stream do you intend to submit? Not known yet, select ‘Unknown’

Please SelectEfficacy and Mechanism EvaluationHealth Services and Delivery Research Health Technology AssessmentInvention for Innovation NHS Physical Environment Research and DevelopmentNIHR Career Development FellowshipNIHR Clinical Doctoral Research FellowshipNIHR Doctoral Research FellowshipNIHR Knowledge Mobilisation Research FellowshipNIHR Post-doctoral FellowshipNIHR Research ProfessorshipNIHR Senior Research FellowshipNIHR Transitional Research FellowshipProgramme Development GrantProgramme Grants for Applied ResearchPublic Health ResearchResearch for Patient BenefitThe Policy Research ProgrammeUnknownOtherIf ‘Other’ please specify

For which submission deadline date (dd/mm/yyyy) are you aiming?

What stage of the application do you need advice on?Outline Full/Single Stage Application

More about your research proposal (if applicable)

Is this a previously submitted rejected NIHR Research for Patient Benefit (RfPB) proposal?Please SelectYesNo

At what stage of the application process did it fail? Please SelectOutline (stage 1)Full (stage 2)

Please send any comments made by the preliminary scrutiny committee and/or the Peer Reviewers.

What kind of support or advice would you like from the NIHR RDS NW?

Please tick all that apply:

Epidemiology Ethics

Evaluation design Formulating a research question

Health economics Identifying and contacting collaborators

Identifying funding sourcesLiterature Searching/Systematic review

Mixed methods Public involvement

Public Health Qualitative

Statistics Structuring and writing a proposal

Survey design Trials design

Critical Reader/Friend Other – Please specify

Briefly outline your query

Previous advice given for this project

Please tick if you have sought RDS NW advice before concerning this project

Please specify who advised you

If you were assigned an ID please enter here

Involving your R&D office/department

Please tick if you have informed your R&D office/department of this project?

Mailing list and other information

Tick if you want to be added to our mailing list to keep up-to-date with RDS NW/related information

How did you hear about us? Please SelectRDS-NW websiteOther websiteInternet searchAt an eventFrom another RDSFrom an OrganisationFrom a colleagueAdvised beforeOther - Please give details

Please email your completed form as an attachment to . If you have a draft proposal or any other supporting information, please send it as well. We aim to respond to you in two working days. You can contact us on 01524 593209. Alternative methods of contact can be found at .

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Please let others know about the RDS NW. You can help by letting your colleagues know about the service e.g. by placing a link to our website on websites/newsletters/blogsetc. that you have access to or by providing some information about our service at your organisation. For more information on how you can help promote the RDS NW or for materials about the RDS NW, that can make available at your organisation, please contact . Your help is very much appreciated.

**Definitions

Clinical - the individual is a health and social care professional

Clinical academic- the individual holds a clinical academic post

Academic- the individual holds an academic post only

NHS Manager-the individual holds a nonclinical management post within the NHS

Research Design Service North West Advice and support request form - Version 12.3 – 2017-09-22Page 1 of 3