Directed Research LOI Outline
Project Title
Amount Requested
Proposed start date and proposed completion date
Is this a re-submission?
Other funding:
- I have submitted this proposal for funding from (NIH, OREF, other)
- This proposal has received funding from
- I have not submitted this proposal for funding from any other organization
- Related projects have received funding (List title/s and funding source/s below)
Principle Investigator name and contact information
Membership category
SRS Member(s) Involved
Institution
Signing Official
Research Team (In case of multicenter project: Specify lead investigator for each participating center)
Location where research is to be performed (In case of multicenter project: Specify participating centers, and what they will contribute)
The Problem – identify the problem to be studied
Hypothesis and Goals
Study Proposal/Methods – Provide a description of the methodology to test hypothesis/hypotheses, and anticipated results. If applicable, provide a brief anticipated sample size calculation. If sample size is not applicable, please provide rationale.
Previous Work in this Area
Budget/Timeline – Briefly describe how these aims can be accomplished with the budget and timeline provided for this grant. If the scope of the application is beyond the budgetary and timeline limitations, please describe if/how outside funding sources or research programs will make up for the shortfall. Please note: travel expenses and indirect costs are not allowed.
Feasibility – Briefly describe the experience/collaborative history of the research team and available resources and how these will ensure the likelihood of success in carrying out the proposed research.
Keywords (up to 5)
Lay Summary
Conflict of Interest Disclosure -
Upload Letters of Support (Optional)
Directed Research Full Application Outline
Project Title
Resubmission? If so, how was it revised?
Total Amount Requested
Project Start Date and Project End Date
Supplemental Information
- Work currently in progress?
- Applied elsewhere for support?
- Does this project utilize a database from a study group? If yes, explain your relationship to this study group and clarify how this is an otherwise unfunded project.
- Please disclose any industry support for and/or participation in this or related projects.
Principal Investigator Information
Identify if PI or Co-Investigator is SRS Member
Institution
Facilities available
Financial Officer Information
Marketing Contact Information
Research Team- In case of multicenter project: Specify lead investigator for each participating center
Collaborating Investigator(s) Information
Project location/s- In case of multicenter project: Specify participating centers, and what they will contribute
Lay Summary
Abstract (not to exceed 200 words)
Budget – Summary and Justification (all personnel costs should be explained)
Publications/References
Biographical Sketches (Max 5 pages per contributor. Must be combined into one document for upload)
- For Principal Investigator and any Collaborating Investigators, including date of birth, education (BA, BS, MS, PhD, MD) postgraduate training (internship, residency, fellowship), hospital and academic appointments, thesis titles and supervisors, and any relevant publications.
- Template
Upload Research Plan - Limited to 10 pages maximum.
- Should answer at minimum:
- Why is the work important?
- What do you plan to do?
- What has already been done?
- How long will it take you to do the work?
- Should be further organized as follows:
- Specific Aims
- Significance
- Materials and Methods
- Supporting Data (References, appendices, and post-plan images will not count against your page limit.)
Exploratory Micro Grant and Resident/Fellow Research Grant Full Application
Project Title
New submission or Re-submission, if re-submission, how was it revised?
Amount Requested
Proposed Project Period (Start and Completion date)
Applied elsewhere for support?
Disclose any industry support for an/or participation in this or related projects
Received any other funding for this project? If so, from where and how much?
PI Name and contact information
Membership category
SRS Member(s) Involved
Institution
Research Team
Purpose of the project/research question if research project
Impact that your project will have on the SRS mission, your career, or your specialty
Primary outcome measure of success
List up to 3 Keywords
Lay Summary
Abstract
Micro Grant Classification
- Research
- Education
- Observership/Mission
- Advocacy
- Quality/Safety Improvement
- Other
Budget Details 1 Year
IRB Disclosure
Regulatory Disclosure: If a device/drug requiring FDA, EU-MDR, or your local/regional specific regulatory body’s approval is identified as an important component of the study, please indicate the status of those devices/drugs.
- FDA, EU-MDR, or local/regional specific regulatory clearance is NOT APPLICABLE
- The FDA, EU-MDR, or local/regional specific regulatory body has cleared all pharmaceuticals and/or medical devices for the use described in this study
- The FDA, EU-MDR, or local/regional specific regulatory body has not cleared the following pharmaceuticals and/or medical devices for the use described in this study. The following pharmaceuticals and/or medical devices are being discussed for an off-label use
Publications/References
Attach Applicant Biosketch/CV Template (Max 5 pages per PI)
Attach Key Personnel Biosketch/es Template (Max 5 pages per contributor. Must be combined into one document for upload)
Biedermann, Cotrel, New Inv, Standard: Letter of Intent Outline
Project Title
Amount Requested
Location where research is to be performed
Proposed start date and proposed completion date
Is this a re-submission?
Other funding:
- I have submitted this proposal for funding from (NIH, OREF, other)
- This proposal has received funding from
- I have not submitted this proposal for funding from any other organization
- Related projects have received funding (List title/s and funding source/s below)
Principle Investigator name and contact information
Membership category
SRS Member(s) Involved
Institution
Research Team
Problem/Need – Identify the problem to be studied and the unmet need(s) to be addressed.
Significance – Provide the most up-to-date estimate of epidemiology, morbidity, mortality and cost of the problem, and how this project relates to the SRS mission
Hypothesis and Goals
Study Proposal/Methods – Provide a description of the methodology to test hypothesis/hypotheses, and anticipated results. If applicable, provide a brief anticipated sample size calculation. If sample size is not applicable, please provide rationale.
Previous Work in this Area
Budget/Timeline – Briefly describe how these aims can be accomplished with the budget and timeline provided for this grant. If the scope of the application is beyond the budgetary and timeline limitations, please describe if/how outside funding sources or research programs will make up for the shortfall. Please note: travel expenses and indirect costs are not allowed.
Feasibility – Briefly describe the experience/collaborative history of the research team and available resources and how these will ensure the likelihood of success in carrying out the proposed research.
Keywords (up to 5)
SRS Research Agenda: Does this proposal align with any SRS Research Agenda item/s? If so, please list.
Lay Summary
Regulatory Disclosure: If a device/drug requiring FDA, EU-MDR, or your local/regional specific regulatory body’s approval is identified as an important component of the study, please indicate the status of those devices/drugs.
- FDA, EU-MDR, or local/regional specific regulatory clearance is NOT APPLICABLE
- The FDA, EU-MDR, or local/regional specific regulatory body has cleared all pharmaceuticals and/or medical devices for the use described in this study
- The FDA, EU-MDR, or local/regional specific regulatory body has not cleared the following pharmaceuticals and/or medical devices for the use described in this study. The following pharmaceuticals and/or medical devices are being discussed for an off-label use
Conflict of Interest Disclosure -
Biedermann, Cotrel, New Inv, Standard: Full Application Outline
Project Title
Resubmission? If so, how was it revised?
Total Amount Requested
Project Start Date and Project End Date
Supplemental Information
- Work currently in progress?
- Applied elsewhere for support?
- If requesting more than $X per year, are you able to secure additional moneys if SRS only approves partial funding?
- Does this project utilize a database from a study group? If yes, explain your relationship to this study group and clarify how this is an otherwise unfunded project.
- Please disclose any industry support for and/or participation in this or related projects.
SRS Research Agenda: Does this proposal align with any SRS Research Agenda item/s? If so, please list.
Principal Investigator Information
Identify if PI or Co-Investigator is SRS Member
Institution Where Work Will Be Done
Facilities available
Financial Officer Information
Marketing Contact Information
Research Team
Collaborating Investigator(s) Information
Lay Summary
Abstract (not to exceed 200 words)
Budget – Summary and Justification (all personnel costs should be explained)
IRB Disclosure
Regulatory Disclosure: If a device/drug requiring FDA, EU-MDR, or your local/regional specific regulatory body’s approval is identified as an important component of the study, please indicate the status of those devices/drugs.
- FDA, EU-MDR, or local/regional specific regulatory clearance is NOT APPLICABLE
- The FDA, EU-MDR, or local/regional specific regulatory body has cleared all pharmaceuticals and/or medical devices for the use described in this study
- The FDA, EU-MDR, or local/regional specific regulatory body has not cleared the following pharmaceuticals and/or medical devices for the use described in this study. The following pharmaceuticals and/or medical devices are being discussed for an off-label use
Biographical Sketches (Max 5 pages per contributor. Must be combined into one document for upload)
- For Principal Investigator and any Collaborating Investigators, including date of birth, education (BA, BS, MS, PhD, MD) postgraduate training (internship, residency, fellowship), hospital and academic appointments, thesis titles and supervisors, and any relevant publications.
- Template
Upload Research Plan - Limited to 10 pages maximum.
- Should answer at minimum:
- Why is the work important?
- What do you plan to do?
- What has already been done?
- How long will it take you to do the work?
- Should be further organized as follows:
- Specific Aims
- Significance
- Materials and Methods
- Supporting Data (References, appendices, and post-plan images will not count against your page limit.)
Application Documents