Clinical Research Recruitment Materials Request
General Information
What materials are you requesting?
Flyer
Internal and/or external advertising
Both
Neither
Requester's Name
IRB Protocol Number
Requester's Email
In lay terms, what is the focus or study of this goal?
Enrollment criteria
What will participants be required to do?
Is compensation provided?
Yes
No
Who is the study director or principal investigator?
Department
Who is the study coordinator?
Phone number for volunteers to call:
Email address for volunteers to email
Note: This email address MUST be in your IRB protocol and approved
Where should materials be delivered? (Include name, building, room number and mail code)
Is this study grant supported or industry supported?
Grant Supported
Industry Supported
How many volunteers are needed?
What is your budget number?
What is your fund number?
How many estimated people will need to be screened to reach enrollment?
What is the advertising budget?
Marketing and Communications will make recommendations based on the target audience and will follow-up.
Pull by date for materials (estimate enrollment time. Flyers without pull by dates are removed from bulletin boards):
Contact Information