Request Form

Statistical Support Request Form

Thank you for contacting the Biostatistics Core of the Centre for Quantitative Medicine at Duke-NUS Medical School. Please briefly tell us about your request by completing the online form or you may download the form and email to our mailing address at biostatcore.cqm@duke-nus.edu.sg.

Requestor

* Name

* Designation

Faculty / Division / Department

Institute / Organization / Company

Email address

Contact Number

Principal Investigator

Name

Designation

Faculty / Division / Department

Institute / Organization / Company

Email address

Support needed

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Funding

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Grant details

Grant scheme

Funding body

Submission date (Note: This should be at least 6 weeks prior)

Type of study

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Study details

(Please provide a brief overall description of the study of interest. You may copy-paste here or attach with this form.)

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Acknowledgement

Principal investigator agrees to include supporting statistician(s) as a co-author in the manuscripts as per the International Committee of Medical Journal Editors (ICMJE) recommendations.

For grant development support (study design, sample size, statistical analysis planning):

Principal investigator agrees to include a budget for statistical support as agreed with the Centre for Quantitative Medicine in the grant.

Principal investigator agrees to include the supporting statistician as a co-investigator or collaborator in the grant application.

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