Research Request Form

Please complete the following on-line form and submit the below list of materials to researchrequests@jasa.org. You may also submit a link to the materials if they are located on a public shared drive.

Materials required for submission:

Research proposal and related materials
IRB communications and all approvals
Proposed informed consent form to be used, if relevant
Tools to be used
Proof of HIPAA training within the past two years if requiring access to a Covered Entity
Proof of Human Subjects training if relevant

JASA’s Research Committee will review requests within 30 days after all materials are received.

fieldset1

Names, titles and institutional affiliations of other researchers

Research

Title of research

Brief description of proposed research including hypotheses and goals

Target population (geographic area, demographics, functional status, and number of participants, etc.)

Expected project time frame

Proposed procedures and protocol for activities taking place at JASA sites

Recruitment and compensation plan (if relevant)

Client information required and how it will be used

Potential impact (risk) on the research subjects

Name(s) of project funder(s)

The research project will adhere to JASA's policies, confidentiality and publication requirements.