Proposal Applications | The Forum | Orthopedic Sports Medicine

Name *

Institutional Affiliation *

Date Submitted *

Project Title *

Project Dates *

Project Total Costs *

Existing Research Support (If applicable/needed for this proposal.)

Other Pending Research Support (If needed for this project.)

Pending Support	Award Date	Amount
Pending Support Source E	Award Date E	Amount E
Pending Support Source F	Award Date F	Amount F
Pending Support Source G	Award Date G	Amount G
Pending Support Source H	Award Date H	Amount H

How will the research plan be altered if the other pending support is not awarded?

Regulatory Assurances

Please list any applicable regulatory approvals that will be required to carry out this proposal.

Committee	Institution	Approval Date	Approval Number	Exemption?
Committee A	Institution A	Approval Date A	Approval Number A	Exemption A
Committee B	Institution B	Approval Date B	Approval Number B	Exemption B
Committee C	Institution C	Approval Date C	Approval Number C	Exemption C
Committee D	Institution D	Approval Date D	Approval Number D	Exemption D

Budget (Maximum $5000)

For each section, please include an itemized list (including item and cost) along with a brief justification.

Equipment

Item	Number/Amount	Cost Per Item	Total
Equipment Item A	Number/Amount A	Cost Per Item A	Total A
Equipment Item B	Number/Amount B	Cost Per Item B	Total B
Equipment Item C	Number/Amount C	Cost Per Item C	Total C
Equipment Item D	Number/Amount D	Cost Per Item D	Total D
Equipment Item E	Number/Amount E	Cost Per Item E	Total E
Equipment Item F	Number/Amount F	Cost Per Item F	Total F
Equipment Item G	Number/Amount G	Cost Per Item G	Total G
Equipment Item H	Number/Amount H	Cost Per Item H	Total H

Equipment Total

Supplies

Item	Number/Amount	Cost Per Item	Total
Supplies Item A	Number/Amount A	Cost Per Item A	Total A
Supplies Item B	Number/Amount B	Cost Per Item B	Total B
Supplies Item C	Number/Amount C	Cost Per Item C	Total C
Supplies Item D	Number/Amount D	Cost Per Item D	Total D
Supplies Item E	Number/Amount E	Cost Per Item E	Total E
Supplies Item F	Number/Amount F	Cost Per Item F	Total F
Supplies Item G	Number/Amount G	Cost Per Item G	Total G
Supplies Item H	Number/Amount H	Cost Per Item H	Total H

Supplies Total

Other (Including Personnel)

Item	Number/Amount	Cost Per Item	Total
Other Item A	Number/Amount A	Cost Per Item A	Total A
Other Item B	Number/Amount B	Cost Per Item B	Total B
Other Item C	Number/Amount C	Cost Per Item C	Total C
Other Item D	Number/Amount D	Cost Per Item D	Total D
Other Item E	Number/Amount E	Cost Per Item E	Total E
Other Item F	Number/Amount F	Cost Per Item F	Total F
Other Item G	Number/Amount G	Cost Per Item G	Total G
Other Item H	Number/Amount H	Cost Per Item H	Total H

Other Total

Overall Budget Total

Research Plan

Layperson Summary

In five sentences or less, please describe your research and its clinical significance in terms understandable by persons not trained in the biomedical sciences

Project Objectives (Aims)

Provide the objectives of the proposed study, including what the study will accomplish and how it will be accomplished, and any hypotheses that will be tested. Please present this as a list of specific research questions that are objectively measurable, along with how you plan to measure them.

Background

Provide a concise description of the background for the proposed study. Include a citation to published paper(s) on this subject that will help the Committee evaluate this application. Make sure to articulate a justification for the gap in the current knowledge that this study will fill

Clinical Relevance

Describe how your project will change the way we think about clinical problems or how we treat them.

Methods and Procedures

Provide a description of what you plan to do. Include all the larger steps, and enough detail to let the committee understand what exactly you will be doing.

Power Analysis and Statistical Analysis

Provide the power analysis or other explanation for your sample size. Also include a brief summary of your data analysis plans.

Feasibility

Provide information to support the feasibility of conducting the proposed study. This includes cost, time, availability of subjects if applicable, availability of materials, collaborators, lab space, etc.

References

This should not be an exhaustive review, but rather key publications that will help the committee understand the basis for, importance of, and feasibility of your proposed research.

Attach Your Curriculum Vitae

(2-3 page biosketch is sufficient)

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