Award year
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Please download the application instructions and document templates required for your submission. You will be prompted to upload your completed documents as part of your application.
INFORMATION WEBINAR SLIDES: The slides provide an overview of the 2020 Pilot Studies Program Request for Application and available resources and services.
APPLICATION INSTRUCTIONS: Please review the application guidance and requirements before continuing with your application submission.
STAKEHOLDER ENGAGEMENT PLAN TOOLKIT: The toolkit provides practical advice on stakeholder engagement plan development, describes its review process and criteria in detail, and presents three case studies to illustrate some potential approaches that applicants may want to consider when developing their stakeholder engagement plans. (PLEASE NOTE: This is a revised version that includes three case studies.)
RESEARCH STRATEGY: Only one research strategy document is required per application.
APPLICANT CERTIFICATION AND AUTHORIZATION FORM: Only one certification and authorization form is required per application. The form must be completed by the project's lead site.
BIOSKETCH INSTRUCTIONS AND SAMPLE: Please read the instructions carefully and then download the biosketch template to be completed by all named senior/key personnel.
BIOSKETCH TEMPLATE: A completed biosketch is required for all named senior/key personnel at each participating site.
BUDGET AND BUDGET JUSTIFICATION FORM: A completed budget and budget justification form is required for each participating site. Please name your documents using the following convention: "PI Last Name_Budget __Site#", for example: Smith_Budget_Site2".
Document download section end
Project title
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Project descriptionPlease provide an abstract or a brief description of your project (maximum 250 words)
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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 your study 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)
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Please check all that apply
The option "
Project research area(s)
For additional information on program research areas, please visit the Tufts CTSI website * must provide value
Please check all that apply
Project information section end
Award type
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Single site award Multi-site award
Number of sites
* must provide value
2 3
PLEASE NOTE: the schools and centers of Tufts University are considered one site for the purposes of this program. For example, if your project includes Tufts University School of Medicine and Tufts University School of Engineering, both schools count as one site, not two.
Award information section end
APPLICANT CERTIFICATION AND AUTHORIZATION FORM: Please upload the completed and signed applicant authorization and certification form as scanned PDF.
* must provide value
RESEARCH STRATEGY: Please upload the completed research strategy 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
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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.
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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
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BIOSKETCH : Please upload your completed biosketch.
* 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
BIOSKETCH : Please upload biosketch for Collaborator 1.
* 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
BIOSKETCH : Please upload biosketch for Collaborator 2.
* 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
BIOSKETCH : Please upload biosketch for Collaborator 3.
* 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
BIOSKETCH : Please upload biosketch for Collaborator 4.
* 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
BIOSKETCH : Please upload biosketch for Collaborator 5.
* must provide value
BUDGET FORM: Please upload a completed budget and budget justification form for SITE 1 (LEAD, required).
* must provide value
BUDGET FORM: Please upload a completed budget and budget justification form for SITE 2 (COLLABORATOR, if applicable).
BUDGET FORM: Please upload a completed budget form for SITE 3 (COLLABORATOR, if applicable).
Please indicate how many letters of support and/or additional documents you would like to upload.
None 1 2 3 4 5 6
DOCUMENT 1 : Please upload document 1 for review.
DOCUMENT 2 : Please upload document 2 for review.
DOCUMENT 3 : Please upload document 3 for review.
DOCUMENT 4 : Please upload document 4 for review.
DOCUMENT 5 : Please upload document 5 for review.
DOCUMENT 6 : Please upload document 6 for review.
Has the Research Team for this proposal - PI, Co-PI(s), and/or Co-I(s) - previously worked together on a research project as investigators (any combination of PI(s), Co-PI(s), or Co-I(s))?
Yes No
Has the Research Team for this proposal - PI, Co-PI(s), and/or Co-I(s) - previously worked together on a research project in capacities other than investigators; for example, one or more persons contributing as a consultant, providing assistance with recruitment, etc.?
Yes No
Is the proposed project part of a larger or closely related/duplicative research project already funded by an internal and/or external funding agency?
Yes, this project builds on the already funded project. No, this project has not received previous funding.
Funding agency(ies) of the already funded project(s)
Please check all that apply
Funding agency(ies), federal
Please check all that apply
Funding agency(ies), foundation
Please check all that apply
Funding agency(ies), industry
Funding agency(ies), Tufts Internal
Please check all that apply
Funding agency(ies), other
Project title(s) of the already funded project(s)
Does the Research Team have an application with overlapping aims currently under review by a federal agency?
Yes No
Federal agency(ies) of the concurrent application(s)
Please check all that apply
Concurrent funding section end
APPLICANT CERTIFICATION AND AUTHORIZATION
* must provide value
I, (as PI), certify that the statements herein are true, complete, and accurate to the best of my knowledge. If a Pilot Studies Program funding is awarded, I agree to accept responsibility for scientific conduct of the project, providing the required progress and outcomes reports, and complying with the Tufts CTSI pre- and post-award requirements outlined in the Request for Applications. I also accept responsibility for payment of any and all over-expenditures should they occur as a result of this project. Citation Requirements Long-term Outcomes Tracking
Principal Investigator Signature
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Please type in your first name and last name.
Principal Investigator Signature Date
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Today M-D-Y
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