CTSI Service Request Form

The CTSI offers a variety of services to facilitate research within the institution. Please take a moment to review our services and select what is most appropriate for your needs.

If you have questions regarding services or this form, please contact us at ctsi@wakehealth.edu.

The option "" can only be selected by itself. Selecting this option will clear your previous selections for this checkbox field. Are you sure?

M-D-Y

Biostatistics Core

Community Engagement

Consultation, General

Data Extraction

Editing (Grants)

FDA Support (IND/IDE)

Health Equity/Special Populations

Implementation Science Consultation

Primate Program Consultation

Recruitment

REDCap

Research Navigation

Research Studio

Study Coordinator

Team Effectiveness Consultation

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CTSI Services Definitions

Attachment:

CTSI Services Definitions Sept 2019.docx

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Yes

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Yes

Yes

Yes

Yes

Yes

Pre-Site Selection Coordinator Services (available for Industry Sponsored studies only)

Regulatory related to IRB (Wake Health) submissions

Regulatory related to Grant/Sponsor submission

Start-up

Screening/Recruitment

Patient Management

Data Management

Specimen collection

Study Close-out

Record Retention

This option is not available for Non-Industry Sponsored studies

If Study Coordinator support is needed after your site is selected for study participation, then you will need to submit a new request for Study Coordinator services.

Pre-site Selection Coordinator Services include:

Consultation meeting with Investigator

Receipt and completion of feasibility questionnaire

Site Qualification meeting preparation

Site Qualification meeting attendance

Please upload a synopsis where it asks for a protocol below, if a protocol is not yet available.

I agree

M-D-Y

Upload file

Yes

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If you have questions, please review the FAQ Guide.

Attachment:

BERD_Consulting_Unit_FAQs_v3 (1).pdf

Grant development

Data analysis

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M-D-Y

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Yes

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M-D-Y H:M

Industry-Initiated Budget Management

WakeOne Research Navigation

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Consultation

Training

New record registration

Results submission

Solve record problems

Open/edit user accounts

Other

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Project Build (Fee-for-Service)

General Consultation

REDCap Basics Class

REDCap Advanced Class

Other

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Yes

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Grant/Proposal

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New

Resubmission

Pre-proposal/Letter of Intent

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Yes

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M-D-Y

Upload file

Editing Text

Drafting Letters of Support

M-D-Y

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Yes

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Consultation prior to IRB submission

Letter of Support

I-DSMB Review

Other

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Cancer Center

Pepper Center (OAIC supported studies)

Not from one of the Centers listed

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Since your study is supported through the Pepper Center, additional assistance is available from the Pepper Center DSMB. Please contact Kim Kennedy at (336) 713-8567 or kkennedy@wakehealth.edu.

Yes

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M-D-Y

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Feasibility Numbers

Recruitment

Other

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Yes

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Yes, I have a patient count from a previously ran i2b2 query.

Yes, I can provide a collected patient list of MRNs.

No, I want help generating a patient list based on my inclusion/exclusion criteria.

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Someone from the Data Team will e-mail you with a folder location to provide your identified patient list in a secure manner.

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Yes

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M-D-Y

Biostatistics

Informatics

Grantsmanship

Content Expertise

Process/Methods Expertise

Ethics

Epidemiology

Career Development

Implementation

Study Design

Hypothesis/Aims

Response to reviewer critiques

Other

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I have a question or an idea I'd like to discuss

I want to arrange a speaker for an event

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Advertisement Design and Marketing

Be Involved support

Recruitment Plan Consultation

General Information

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Yes

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Yes

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Please complete the BeInvolved Study Add/Change Request Form.

Youth (17 and younger)

Older Adults (65 and older)

Racial/ethnic minorities

N/A, this request is unrelated to a special population

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If your needs involve receiving animals, tissues/samples, or data from the Vervet Research Colony, Please complete the Vervet Colony Request Form.

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Research Participant Navigation

Consultation

Training

Language Services

Other

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Participant consenting (Spanish)

Participant follow up

Participant recruitment

Data/Feasibility Review

Study Design

Pipeline Education

Health Literacy

Implicit Bias

Cultural Humility

Other

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On-site language interpretation

Document translation

Video remote interpreting

Contact/Consent with study subject

Participant follow-up

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If you are interested in the Voucher Program to support a special population with a transportation, care-giving, or advertisement need, please complete a Voucher Program Application.

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Individual Consultation

Team-Based Consultation

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Yes

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Required format:

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