The code block below illustrates how one might use # and // as comments in your logic and calculations.

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The value you provided must be within the suggested range

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The value entered must be a time value in the following format HH:MM within the range 00:00-23:59 (e.g., 04:32 or 23:19).

This field must be a 5 or 9 digit U.S. ZIP Code (like 94043). Please re-enter it now.

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The value you provided could not be validated because it does not follow the expected format. Please try again.

Required format:

DOCR Services Request

Thank you for your interest in services available from DOCR.

Please complete this brief survey and a representative will be back in touch with you in two business days.

NOTE: DOCR CRC services are provided through the DOCR Service Center. To request CRC services, please complete the DOCR Service Center Intake Form.

First Name:

* must provide value

Last Name:

* must provide value

Email:

* must provide value

First Name:

Last Name:

Email:

Project Title:

Projected Start Date:

M-D-Y

Please indicate your primary affiliation:

* must provide value

Please define your affiliation:

Purpose of this project:

IRB number:

Please specify:

What type of services are you requesting?

RMT Data Team Support

Study Planning Services

Project Management/RPL Support

DOCR CRC services are provided through the DOCR Service Center. To request CRC services, please complete the DOCR Service Center Intake Form.

Study Coordination Services:

Develop/Manage regulatory submissions

Write/edit study materials

Recruit/screen and informed consent

Conduct and plan study visits, data collection

Data entry and QA

Manage Investigational products and supplies

Biology sample collection/handling

Meetings and communications

Reports and publications

RN skills required

Pediatric population

Adult population

Percent of effort being requested:

Data Management Services:

REDCap database build and/or maintenance

REDCap survey build and distribution

Support for REDCap database and/or survey built by study team

Data cleaning/merging/uploading

Other

Please specify:

Budget Development and Negotiation Assistance:

Internal Cost Assessment(ICA)/Budget development

Budget/payment term negotiation

Contract tracking

SPS entry

No-cost extensions

Closeout completion

Study Planning Services:

Grant planning assistance

IRB planning and navigation

Mobile health technology

Recruitment planning

Please provide any additional information or services needed.
Examples would be effort, schedule preferences, etc.

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