Please complete the following survey regarding use of Department of Radiology and/or Imaging Research Center (IRC) resources.

The information collected in this form facilitates planning for upcoming studies and establishing processes and protocols necessary for successful study completion. The collected information will also be used to generate a budget for study related costs.

Completion of this form does not substitute for IRB or IACUC approval. Both IRB/IACUC approval and approval of the Radiology Department are required before study activities can begin. You will receive notification when the Radiology Department has approved your resource request.

Failure to complete this form will result in delayed availability of imaging resources.

If you have a questions about the Radiology Department intake process or this form contact:

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