Research Project Data Collection Form
Who should use this form?
This form is intended for Clinical Psychology Trainees who are both:
Employees of Camden & Islington Mental Health and Social Care Trust, and
Conducting research in organisations other than the Care Trust, Camden PCT, Islington PCT,
Barnet PCT, Enfield PCT or Haringey PCT
This information is being collected for research governance purposes and to ensure the
appropriate indemnity cover is in place before you begin your research.
Why do we need this form?
All research supported by the Care Trust, (either in its own services or if conducted by Care Trust
staff at other sites) must be conducted in accordance with the Department of Health Research
Governance Framework for Health and Social Care. It is a requirement of research governance
that Trusts need to be aware of such research.
We therefore ask that you complete a version of our project registration form, which has been
abbreviated to take into account that the research will not be taking place in
CAMDEN & ISLINGTON MENTAL HEALTH AND SOCIAL CARE TRUST
CAMDEN PCT
ISLINGTON PCT
BARNET PCT
ENFIELD PCT
HARINGEY PCT
PLEASE NOTE THAT IF YOUR RESEARCH USES THE PATIENTS, STAFF, PREMISES OR OTHER RESOURCES OF
THE ABOVE TRUSTS YOU MUST APPLY FOR APPROVAL TO UNDERTAKE RESEARCH USING A STANDARD
PROJECT REGISTRATION FORM.
Please return to: Angela Williams
Research & Development Unit
3rd Floor, West Wing
St Pancras Hospital, 4 St Pancras Way
London NW1 OPE
FAX: 020 7530 3235
or by e-mail: angela.williams@camdenpct.nhs.uk (including scanned documentation required)
If you have any problems completing this form, please contact 0207 530 3944
If you have any comments about the form we would be happy to receive them.
The North Central London Community Research Consortium is a partnership between Camden Primary Care Trust,
Islington Primary Trust, Camden & Islington Mental Health and Social Care Trust and the North Central Thames Primary
Care Research Network
(NoCTeN)
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Research Project Data Collection Form for Clinical Psychology Trainees
1. Name:
2. Telephone number:
3. e-mail:
4. Title of the project:
5. Academic Institution:
6. Supervisor:
7. Supervisor Telephone number:
8. Supervisor e-mail:
9. NHS organisation(s) where participants are being recruited for the project. (If recruited through
primary care, give PCT; if not being recruited through the NHS state how recruitment will be
conducted, any non-NHS bodies involved and give the geographical area).
10. All NHS organisations named above (at question 9) need to give approval for your research.
Please provide a copy of the approval letter or give contact details of the R&D office that has
approved your research (if possible quoting any reference number they have issued you with)
11. Please indicate which Research Ethics Committee this project has been reviewed by.
Please attach copies of letters with appropriate reference number(s)
12. Your ethics application form will have asked you about indemnity or insurance for the project.
Please reproduce the information you gave.
13. Project start date:
The North Central London Community Research Consortium is a partnership between Camden Primary Care Trust,
Islington Primary Trust, Camden & Islington Mental Health and Social Care Trust and the North Central Thames Primary
Care Research Network
(NoCTeN)
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14. Project end date:
The North Central London Community Research Consortium is a partnership between Camden Primary Care Trust,
Islington Primary Trust, Camden & Islington Mental Health and Social Care Trust and the North Central Thames Primary
Care Research Network
(NoCTeN)
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