Research application form

Data custodians of the ABJHI data repository may request their own data at any time, apart from the intake process. If the custodian wishes to link their data with data from other custodians, or have analysis completed for their data, the request will proceed through our research intake process.

ABJHI accepts PayPal or cheque. After submitting the application form below, you will be automatically taken to PayPal to process payment of the application fee. Alternatively, you can mail a cheque payable to Alberta Bone and Joint Health Institute to the address below:

Alberta Bone and Joint Health Institute
316, 400 Crowfoot Crescent NW
Calgary, AB T3G 5H6

Review of your application will begin when payment is received.

    1. Primary Contact

    The primary contact is the person to whom all questions about the application will be directed.

    Name (required):
    Email (required):
    Phone Number:
    Mailing Address:
    Organization:

    2. Principal Investigator

    If the Principal Investigator is same as Primary Contact you may leave these fields blank, otherwise specify below.

    Name:
    Email:
    Phone Number:
    Mailing Address:
    Organization:

    3. Study Team

    Please describe any co-investigators, students, etc., including names and title/roles (required):

    Please describe any other partnerships (Strategic Clinical Networks, universities, industry, collaborators), including names and title/roles of collaborators (required):

    4. Ethics Approval Letter and Ethics Application

    Attach copy of approval letter (required at time of application)(max size: 5 MB):

    Attach copy of ethics application (required at time of application)(max size: 5 MB):

    Note: If the ethics application includes all components listed under Section 5 and 6 below, you are not required to fill out these sections.

    5. Project Description

    Project Title:
    Lay Abstract or Rationale:
    Briefly describe your project in plain language so a lay reader with no experience in your research area will understand (250 words/2000 characters)

    Research Question(s):

    Method:
    i. Inclusion and Exclusion Criteria

    ii. Procedure:

    iii. Variables of Interest (data elements required):

    iv. Anticipated Analyses:

    v. Timeline:

    6. Study Protocol

    Attach copy of protocol letter (required at time of application)(max size: 5 MB):

    7. Services Required from ABJHI

    Requested Service(s): (check all that apply)

    Requested Resource(s): (check all that apply)

    8. Alignment with ABJHI Research Priorities

    Briefly describe how the proposed research project aligns with the ABJHI mandate and research priorities.

    A copy of the submitted application will be emailed to you for your records. After you submit the form, please submit the application fee (via PayPal or cheque).