Research Letter of Intent Form

This form is for Research Studies only. If you would like to submit a Letter of Intent for an Evidence-based Practice project, please click here.

DAISY Foundation Grants are only available if your Principal Investigator is a RN. Please confirm this is true below.

Date

Name of Proposed Study:

SHORT Name of Proposed Study (50 characters maximum):

Our grants are dedicated to the treatment of patients/families with cancer or auto-immune diseases. What is your proposal for?

How did you learn about the J. Patrick Barnes Grant program?

Please tell us about your Principal Investigator:

First Name

Last Name

Credentials:

Title:

Phone

Additional Team Member

If there are additional people on your team please add them below-in the following format:

Name:

Title:

Credentials:

Role in Study:

You may list up to 5 team members total:

Additional Team Member #1

Additional Team Member #2

Additional Team Member #3

Additional Team Member #4

Additional Team Member #5

Institution Information:

Institution Name:

Street:

City

Country

State

Provinces

State/Province

Postal Code

Study Proposal Information

Background: (Maximum 250 words):

Purpose of Study/Description of how this study/project will benefit cancer or auto-immune disease patients and/or family, in keeping with DAISY Foundation's stated goal (Maximum 200 words):

General outline of study: Methods/Sample/Setting/Procedure (Maximum 250 words):

Specific description of how clinical nurses will be involved in the study (e.g. conceptualization, data collection, analysis, reporting): (Maximum 250 words)

We strongly encourage our applicants to have mentors for their work, especially if you are not a highly experienced researcher. Hopefully a mentor will be available in your own institution or a nearby college/school of nursing.

Do you have a mentor to help guide your study?

Do you plan to apply to DAISY for subsequent funding to help you disseminate your findings?

Acknowledgement

By checking this box and submitting the online form, you agree to The DAISY Foundation collecting and storing your personal contact information. We may contact you if we have questions about your submission or to discuss next steps. To learn more, please read our Privacy Policy.

I Agree

If the form becomes stuck on "please wait" or you are not re-directed to our to another page after you hit submit, please email Erin Ascher at ErinAscher@DAISYFoundation.org to confirm we have received your submission. Thank you!

Contact Information