Award year
* must provide value
Please download the Letter of Intent template required for your submission. You will be promted to upload your completed document as part of your application. When you click on the link to download the template, you will be asked "Do you want to leave this site? Changes you made may not be saved." Please select LEAVE. Do not worry, your online application will not be affected. Alternatively, you can right-click on the link and select "open in new tab."
The Letter of Intent narrative may not exceed two pages in length. Please use Arial at a font size of 11 points and keep all margins at 0.5 inches.
Below are the key components that must be addressed in the Letter of Intent:
Brief description of the proposed study, including a brief statement of the study’s hypothesis and specific relevance to human health, written in language intended for the lay public. Potential benefits of the proposed study and the importance of the knowledge that reasonably may be expected to be gained. Description of how the proposed study will translate into direct impact on human health, including an overview of the translational pathway forward . Specific aims and/or objectives of the proposed study. Project feasibility statement 1) explaining in what way, if any, the proposed study can be impacted by the COVID-19 pandemic; and 2) describing what measures can and will be taken to ensure successful completion of the project within the award period despite possible COVID-19-related closures and/or associated restrictions on research activities. Additional guidance for investigators proposing research that involves a foreign component , as defined by NIH:
Provide a list of specific element(s) or segment(s) of the project that are intended to be performed outside of the U.S., by a non-U.S. vendor and/or collaborator employed by a foreign entity. Disclose any collaborations with investigators at a foreign site anticipated to result in co-authorship; use of facilities or instrumentation at a foreign site; or receipt of financial support or resources from a foreign entity. LETTER OF INTENT TEMPLATE:
Project title
* must provide value
Translational research phase(s)
For additional information on the translational research phases, please visit the Tufts CTSI website * must provide value
Please check all that apply
The option "
Does your study involve human or animal subjects?
For more information on human subjects research, please see the NIH definition available at Grants.NIH.gov * must provide value
Please check all that apply
Does the proposed research meet the NIH definition of a clinical trial?
For more information, please see the NIH definition of a clinical trial at Grants.NIH.gov * must provide value
Yes
No
Not sure
Early Phase 1
Phase 1
Phase 1-2
Phase 2
Phase 2-3
Phase 3
Phase 4
Not sure
PLEASE NOTE: Tufts CTSI can only support clinical trial activity through the end of Phase IIB.
The option "
Required regulatory approval(s)
* must provide value
Please check all that apply
Is any element or segment of the proposed research intended to be performed outside of the U.S., by a non-U.S. vendor, or a collaborator employed by a foreign entity? If applicable, is the partnership with a collaborator at a foreign site anticipated to result in co-authorship, use of facilities or instrumentation at a foreign site, or receipt of financial support or resources from a foreign entity?
* must provide value
Yes No
Project information section end
Award type
* must provide value
Single site award Multi-site award
Number of eligible sites
* must provide value
2 3
Award information section end
LETTER OF INTENT: Please upload the completed Letter of Intent form.
* must provide value
Project documents section end
All proposals must designate a PI with a primary appointment or position at a Tufts CTSI-affiliated partner organization. To see a list of eligible organizations, please visit the Tufts CTSI website . For questions or assistance, please reach out to the Pilot Studies Program Team at pilots@tuftsctsi.org . Title or position
* must provide value
First name
* must provide value
Last name
* must provide value
Degree(s)
* must provide value
Check all that apply
Degree(s), other
* must provide value
Primary affiliation
* must provide value
Action for Boston Community Development (ABCD) Asian Community Development Corporation Asian Task Force Against Domestic Violence Asian Women for Health Baystate Medical Center Blue Cross Blue Shield of Massachusetts Boston Chinatown Neighborhood Center Brandeis University Center for Information and Study on Clinical Research Participation (CISCRP) Greater Boston Chinese Golden Age Center Health Resources in Action Institute for Clinical Research and Health Policy Studies Lahey Hospital and Medical Center Maine Medical Center Massachusetts General Hospital Institute of Health Professions Massachusetts Institute of Technology Massachusetts Biotechnology Council Museum of Science - Boston New England Baptist Hospital New England Quality Care Alliance Newton-Wellesley Hospital Northeastern University Novartis Pfizer Inc. RAND Corporation St. Elizabeth's Medical Center The Jackson Laboratory Tufts Health Plan Tufts Medical Center Tufts University
School or center
* must provide value
Tufts University Sackler School of Graduate Biomedical Sciences Tufts University School of Engineering Tufts University Cummings School of Veterinary Medicine Tufts University Fletcher School of Law and Diplomacy Tufts University Friedman School of Nutrition Science and Policy Tufts University School of Dental Medicine Tufts University School of Arts and Sciences Tufts University Tisch College of Citizenship and Public Service Tufts University Jean Mayer USDA Human Nutrition Research Center on Aging Tufts University School of Medicine Tufts Center for the Study of Drug Development Other
School or center, other
* must provide value
DepartmentPlease provide the department name. If your organization does not have a department, simply input N/A.
* must provide value
Student or trainee statusPlease specify your student or trainee status, if applicable.
* must provide value
Clinical Fellow Clinical Intern Clinical Resident Student T Awardee K Awardee Other Not applicable
Student or trainee status, other
* must provide value
Academic rankPlease specify your academic rank, if applicable.
* must provide value
Distinguished Professor Professor Associate Professor Assistant Professor Lecturer Instructor Adjunct Professor Clinical Associate Other Not Applicable
Academic rank, other
* must provide value
Email addressPlease provide email address associated with your primary affiliation.
* must provide value
Phone numberPlease provide phone number associated with your primary affiliation.
* must provide value
Business addressPlease provide mailing address associated with your primary affiliation.
* must provide value
State
* must provide value
Alabama Alaska Arizona Arkansas California Colorado Connecticut Washington D.C. Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Zip code
* must provide value
PRINCIPAL INVESTIGATOR section end
Research teams may include collaborators who are and who are not affiliated with Tufts CTSI. Please note that each site of a multi-site research project must designate an investigator with a primary appointment or position at a Tufts CTSI partner organization who will serve as a lead contact (site PI) at that site.
Number of senior/key collaborators
* must provide value
None 1 2 3 4 5
COLLABORATOR 1 INFORMATION Collaborator's role on the project:
* must provide value
Co-Principal Investigator Co-Investigator Other
Collaborator's role, other
* must provide value
Collaborator's first name
* must provide value
Collaborator's last name
* must provide value
Collaborator's degree(s)
* must provide value
Check all that apply
Collaborator's degree(s), other
* must provide value
Collaborator's primary affiliation
* must provide value
Action for Boston Community Development (ABCD) Asian Community Development Corporation Asian Task Force Against Domestic Violence Asian Women for Health Baystate Medical Center Blue Cross Blue Shield of Massachusetts Boston Chinatown Neighborhood Center Brandeis University Center for Information and Study on Clinical Research Participation (CISCRP) Greater Boston Chinese Golden Age Center Health Resources in Action Institute for Clinical Research and Health Policy Studies Lahey Hospital and Medical Center Maine Medical Center Massachusetts General Hospital Institute of Health Professions Massachusetts Institute of Technology Massachusetts Biotechnology Council Museum of Science - Boston New England Baptist Hospital New England Quality Care Alliance Newton-Wellesley Hospital Northeastern University Novartis Pfizer Inc. RAND Corporation St. Elizabeth's Medical Center The Jackson Laboratory Tufts Health Plan Tufts Medical Center Tufts University Other
Collaborator's primary affiliation, other
* must provide value
Collaborator's school or center
* must provide value
Tufts University Sackler School of Graduate Biomedical Sciences Tufts University School of Engineering Tufts University Cummings School of Veterinary Medicine Tufts University Fletcher School of Law and Diplomacy Tufts University Friedman School of Nutrition Science and Policy Tufts University School of Dental Medicine Tufts University School of Arts and Sciences Tufts University Tisch College of Citizenship and Public Service Tufts University Jean Mayer USDA Human Nutrition Research Center on Aging Tufts University School of Medicine Tufts Center for the Study of Drug Development Other
Collaborator's school or center, other
* must provide value
Collaborator's academic rank
* must provide value
Distinguished Professor Professor Associate Professor Assistant Professor Lecturer Instructor Adjunct Professor Clinical Associate Other Not Applicable
Collaborator's academic rank, other
* must provide value
Collaborator's email
* must provide value
COLLABORATOR 2 INFORMATION Collaborator's role on the project:
* must provide value
Co-Principal Investigator Co-Investigator Other
Collaborator's role, other
* must provide value
Collaborator's first name
* must provide value
Collaborator's last name
* must provide value
Collaborator's degree(s)
* must provide value
Check all that apply
Collaborator's degree(s), other
* must provide value
Collaborator's primary affiliation
* must provide value
Action for Boston Community Development (ABCD) Asian Community Development Corporation Asian Task Force Against Domestic Violence Asian Women for Health Baystate Medical Center Blue Cross Blue Shield of Massachusetts Boston Chinatown Neighborhood Center Brandeis University Center for Information and Study on Clinical Research Participation (CISCRP) Greater Boston Chinese Golden Age Center Health Resources in Action Institute for Clinical Research and Health Policy Studies Lahey Hospital and Medical Center Maine Medical Center Massachusetts General Hospital Institute of Health Professions Massachusetts Institute of Technology Massachusetts Biotechnology Council Museum of Science - Boston New England Baptist Hospital New England Quality Care Alliance Newton-Wellesley Hospital Northeastern University Novartis Pfizer Inc. RAND Corporation St. Elizabeth's Medical Center The Jackson Laboratory Tufts Health Plan Tufts Medical Center Tufts University Other
Collaborator's primary affiliation, other
* must provide value
Collaborator's school or center
* must provide value
Tufts University Sackler School of Graduate Biomedical Sciences Tufts University School of Engineering Tufts University Cummings School of Veterinary Medicine Tufts University Fletcher School of Law and Diplomacy Tufts University Friedman School of Nutrition Science and Policy Tufts University School of Dental Medicine Tufts University School of Arts and Sciences Tufts University Tisch College of Citizenship and Public Service Tufts University Jean Mayer USDA Human Nutrition Research Center on Aging Tufts University School of Medicine Tufts Center for the Study of Drug Development Other
Collaborator's school or center, other
* must provide value
Collaborator's academic rank
* must provide value
Distinguished Professor Professor Associate Professor Assistant Professor Lecturer Instructor Adjunct Professor Clinical Associate Other Not Applicable
Collaborator's academic rank, other
* must provide value
Collaborator's email
* must provide value
COLLABORATOR 3 INFORMATION Collaborator's role on the project:
* must provide value
Co-Principal Investigator Co-Investigator Other
Collaborator's role, other
* must provide value
Collaborator's first name
* must provide value
Collaborator's last name
* must provide value
Collaborator's degree(s)
* must provide value
Check all that apply
Collaborator's degree(s), other
* must provide value
Collaborator's primary affiliation
* must provide value
Action for Boston Community Development (ABCD) Asian Community Development Corporation Asian Task Force Against Domestic Violence Asian Women for Health Baystate Medical Center Blue Cross Blue Shield of Massachusetts Boston Chinatown Neighborhood Center Brandeis University Center for Information and Study on Clinical Research Participation (CISCRP) Greater Boston Chinese Golden Age Center Health Resources in Action Institute for Clinical Research and Health Policy Studies Lahey Hospital and Medical Center Maine Medical Center Massachusetts General Hospital Institute of Health Professions Massachusetts Institute of Technology Massachusetts Biotechnology Council Museum of Science - Boston New England Baptist Hospital New England Quality Care Alliance Newton-Wellesley Hospital Northeastern University Novartis Pfizer Inc. RAND Corporation St. Elizabeth's Medical Center The Jackson Laboratory Tufts Health Plan Tufts Medical Center Tufts University Other
Collaborator's primary affiliation, other
* must provide value
Collaborator's school or center
* must provide value
Tufts University Sackler School of Graduate Biomedical Sciences Tufts University School of Engineering Tufts University Cummings School of Veterinary Medicine Tufts University Fletcher School of Law and Diplomacy Tufts University Friedman School of Nutrition Science and Policy Tufts University School of Dental Medicine Tufts University School of Arts and Sciences Tufts University Tisch College of Citizenship and Public Service Tufts University Jean Mayer USDA Human Nutrition Research Center on Aging Tufts University School of Medicine Tufts Center for the Study of Drug Development Other
Collaborator's school or center, other
* must provide value
Collaborator's academic rank
* must provide value
Distinguished Professor Professor Associate Professor Assistant Professor Lecturer Instructor Adjunct Professor Clinical Associate Other Not Applicable
Collaborator's academic rank, other
* must provide value
Collaborator's email
* must provide value
COLLABORATOR 4 INFORMATION Collaborator's role, other
* must provide value
Collaborator's role on the project:
* must provide value
Co-Principal Investigator Co-Investigator Other
Collaborator's first name
* must provide value
Collaborator's last name
* must provide value
Collaborator's degree(s)
* must provide value
Check all that apply
Collaborator's degree(s), other
* must provide value
Collaborator's primary affiliation
* must provide value
Action for Boston Community Development (ABCD) Asian Community Development Corporation Asian Task Force Against Domestic Violence Asian Women for Health Baystate Medical Center Blue Cross Blue Shield of Massachusetts Boston Chinatown Neighborhood Center Brandeis University Center for Information and Study on Clinical Research Participation (CISCRP) Greater Boston Chinese Golden Age Center Health Resources in Action Institute for Clinical Research and Health Policy Studies Lahey Hospital and Medical Center Maine Medical Center Massachusetts General Hospital Institute of Health Professions Massachusetts Institute of Technology Massachusetts Biotechnology Council Museum of Science - Boston New England Baptist Hospital New England Quality Care Alliance Newton-Wellesley Hospital Northeastern University Novartis Pfizer Inc. RAND Corporation St. Elizabeth's Medical Center The Jackson Laboratory Tufts Health Plan Tufts Medical Center Tufts University Other
Collaborator's primary affiliation, other
* must provide value
Collaborator's school or center
* must provide value
Tufts University Sackler School of Graduate Biomedical Sciences Tufts University School of Engineering Tufts University Cummings School of Veterinary Medicine Tufts University Fletcher School of Law and Diplomacy Tufts University Friedman School of Nutrition Science and Policy Tufts University School of Dental Medicine Tufts University School of Arts and Sciences Tufts University Tisch College of Citizenship and Public Service Tufts University Jean Mayer USDA Human Nutrition Research Center on Aging Tufts University School of Medicine Tufts Center for the Study of Drug Development Other
Collaborator's school or center, other
* must provide value
Collaborator's academic rank
* must provide value
Distinguished Professor Professor Associate Professor Assistant Professor Lecturer Instructor Adjunct Professor Clinical Associate Other Not Applicable
Collaborator's academic rank, other
* must provide value
Collaborator's email
* must provide value
COLLABORATOR 5 INFORMATION Collaborator's role on the project:
* must provide value
Co-Principal Investigator Co-Investigator Other
Collaborator's role, other
* must provide value
Collaborator's first name
* must provide value
Collaborator's last name
* must provide value
Collaborator's degree(s)
* must provide value
Check all that apply
Collaborator's degree(s), other
* must provide value
Collaborator's primary affiliation
* must provide value
Action for Boston Community Development (ABCD) Asian Community Development Corporation Asian Task Force Against Domestic Violence Asian Women for Health Baystate Medical Center Blue Cross Blue Shield of Massachusetts Boston Chinatown Neighborhood Center Brandeis University Center for Information and Study on Clinical Research Participation (CISCRP) Greater Boston Chinese Golden Age Center Health Resources in Action Institute for Clinical Research and Health Policy Studies Lahey Hospital and Medical Center Maine Medical Center Massachusetts General Hospital Institute of Health Professions Massachusetts Institute of Technology Massachusetts Biotechnology Council Museum of Science - Boston New England Baptist Hospital New England Quality Care Alliance Newton-Wellesley Hospital Northeastern University Novartis Pfizer Inc. RAND Corporation St. Elizabeth's Medical Center The Jackson Laboratory Tufts Health Plan Tufts Medical Center Tufts University Other
Collaborator's primary affiliation, other
* must provide value
Collaborator's school or center
* must provide value
Tufts University Sackler School of Graduate Biomedical Sciences Tufts University School of Engineering Tufts University Cummings School of Veterinary Medicine Tufts University Fletcher School of Law and Diplomacy Tufts University Friedman School of Nutrition Science and Policy Tufts University School of Dental Medicine Tufts University School of Arts and Sciences Tufts University Tisch College of Citizenship and Public Service Tufts University Jean Mayer USDA Human Nutrition Research Center on Aging Tufts University School of Medicine Tufts Center for the Study of Drug Development Other
Collaborator's school or center, other
* must provide value
Collaborator's academic rank
* must provide value
Distinguished Professor Professor Associate Professor Assistant Professor Lecturer Instructor Adjunct Professor Clinical Associate Other Not Applicable
Collaborator's academic rank, other
* must provide value
Collaborator's email
* must provide value
Principal Investigator Signature
Please type in your first name and last name.
Principal Investigator Signature Date
Today M-D-Y
Please review your information prior to final submission. If you are satisfied with your responses, please click "SUBMIT." You will have a chance to provide your email address to receive a confirmation email.
If you would like to save your progress and return to where you left off to complete the survey later (before the submission deadline), please click "SAVE AND RETURN LATER". Please provide your email address when prompted and save the return code that will be shown on the screen. You will receive an email with a link to return to your application, but the email will NOT contain the return code. Please note that if you lose or forget your return code, DO NOT click on the "Start Over" button, as this will erase all of your data. Instead, please email
pilots@tuftsctsi.org and we will help you return to your unfinished application.
Submit
Save & Return Later
Working...