Bronchiectasis and NTM Association: Project Proposal Review Form

Bronchiectasis and NTM Association: Project Proposal Review Form
Name

First NameLast Name
Institution
Email
example@example.com
Project Information
Proposed Project Name
Proposed Project Output (select all that apply)

Other, please specify
Please provide further information on what data you are looking to access and what it is for (a grant, feasibility, raw data, etc.):
Publication type (select all that apply)

Other, please specify
Abstract: Specify Conference
Publication: Background
Publication: Hypothesis
Publication: Specific Aims
Patient Recruitment: Specify Enrollment Goal
Patient Recruitment: Specify Inclusion/Exclusion Criteria
Sponsor and Timeline
Is there a sponsor involved with this project?
If yes, please specify.
Please indicate the timeline for this request:
Provide the rationale for your timeframe.
Please note, requests for use of the full Registry dataset must be analyzed by an Association biostatistician. For participating BRR and CCN sites, site level data may be analyzed by the site.
To complete and submit form you must click "review" button below. Once answers are reviewed, please click "submit" at the bottom of the form to complete.
Should be Empty:

Project Information