Research Feasibility Intake Form Research Protocol Feasibility Intake Form Utilized by Principle Investigator's for Feasibility Intake Principal InvestigatorName (Last, First) Title Divisions/Institutes Email Point of Contact (If other than PI)Name (Last, First) Email Study DetailsStudy Title Will this study be going through the Office of Clinical Trials? Yes No AttachmentsProtocolMax. file size: 500 MB.Attach Additional Document? (i.e. Division protocol review form, if applicable) Yes No Protocol Feasibility ConsiderationsIs external and/or internal funding sufficient to cover total study budget expenses inclusive of regulatory and non-departmental ancillary program/services? Yes No Unknown N/A Have other departments, clinics, or operational units that may be impacted by, or provide services for, the research (e.g., Clinical Research Unit, Office of Clinical Trials, informatics, pharmacy, nursing, laboratory, and imaging) been informed and agreed to support the conduct of the study? Yes No Unknown N/A Are similar studies open to enrollment or under consideration that will draw from the same subject population? Yes No Unknown N/A If there are similar studies that will draw the same subject population, is there a plan in place to address competing recruitment goals? Yes No Unknown N/A Is there empirical data that a sufficient study population exists from which to recruit subjects? Yes No Unknown N/A Is the secure collection, storage and sharing of data identified? Yes No Unknown N/A Does the investigator possess the adequate time commitment to oversee the study? Yes No Unknown N/A