Children's Environmental Health Initiative

a research, education, and outreach program committed to fostering environments where all people can prosper

Collaboration request

Date of request

Month

Day

Year

Date needed

Month

Day

Year

Your name *

Your email *

Principal Investigator name

Principal Investigator email

Other collaborators

Project name

Project Objectives

IRB Submission Status

In Progress

Submitted but not Approved

Approved

Data available for project

What do you want done with the data?

What resources/tools (e.g. geospatial mapping, statistics, consulting) are you expecting?

What is the proposed deliverable upon completion of your project (e.g. statistical output, formal report, maps, publication)

What is the timeline for completion of your project?

What project management duties will you or your team provide?

Additional Comments

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