PROJECT INFORMATION by MiGX5Hek

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									                                     PROJECT INFORMATION
Prior to commencing MR studies, the following information is required. Please complete and return to
David Schmidt (403.955.7989 or David.Schmidt@albertahealthservices.ca) with your completed
Application for Research Time form.


Investigator:                                                            Department:

Phone:                                                                   E-mail:

Project Title:

Funding Information (Funded Projects Only)

Funding Agency:

Start Date:                                                              End Date:

Account #:                                                                   U of C               AHS

Approvals


Ethics Approval #:                                                       Expiry Date:

Key Personnel
Name                                           Role                                      Phone




Special Requirements/Equipment Needs




Have you discussed this project with ACH/GE/Seaman Centre Imaging Scientist?                YES         NO

If yes, provide name:
RETURN TO: Scientific Review Committee, ACH Diagnostic Imaging, Alberta Children's Hospital, 2888 Shaganappi Trail
NW, Calgary AB T3B 6A8



Project Information Form Version 1
19 December 2011

								
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