Application for Collaboration with the Center for Environment, Place, and Health Research (CEPHR)

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Please describe your research project based on the following information so that we can assess the best personnel to collaborate on the project and understand the needed levels of assistance. If you need additional support prior to submitting this application, please visit clevelandclinic.org/CEPHR or request a consultation here.

For more details regarding this CEPHR application, view the full announcement at the link below:

CEPHR_RFA_2025.pdf

Principal Investigator Name
(Last Name, First Name)

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Administrative Contact
(if different than PI)

Email Address

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Date Request Submitted

M-D-Y

Project Title

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Does your research proposal have IRB approval?

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Yes

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Please provide CCF IRB#

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Is IRB approval pending?

Yes

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Data source(s):

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Please summarize in 2 - 3 sentences what you aim to achieve with your research protocol.

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Study design and population:

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Primary explanatory variables:

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Response variables (outcomes):

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Deadline(s) (if applicable):

Y-M-D

Explain the nature of your deadline, and whether you have multiple deadlines associated with this project.

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Other details related to the project:

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The full study proposal document
Proposal Template

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Have you secured or plan to apply for internal or external funding to support this research project?

Yes

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