| Last name: | |
| First name: | |
| Organization's name: | |
| E-mail: | |
| Phone: | |
|
Research question or
QI objective: |
|
| Reasons you believe this project is important: | |
| Brief review of any relevant literature (put references at the end): | |
| Brief summary of proposed methods: | |
| Possible sources of funding: | |
| How much time would it take to complete the project? | |
| How soon do you want to start the project? | |
| Copy confirmation code: |
![]() |