FLASH Request For Data
The following form will be used to submit a request for data from the FLASH study. The data request will be evaluated by the FLASH Research Group Steering Committee. Please allow up to four weeks for processing. If further information is needed you will be contacted via email.
Sign in to Google to save your progress. Learn more
Name *
Please enter your name
Title *
Please enter your title
Affliation *
Please indicate the name of the university or organization you are affiliated with
Department *
Please enter the name of your department
Email *
Please enter your email address
Phone number *
Please enter your phone number if the following format: 123-456-7890
State the research question and briefly describe the intended research (max. 450 characters) *
Primary exposure of interest (independent variable)? *
Primary outcome of interest (dependent variable)? *
Other variables of interest? (max. 450 characters) *
Type of analysis *
Required
Purpose for the request? *
Please note manuscript/publication and grant proposal requests will be prioritized
Required
Intended date of submission *
MM
/
DD
/
YYYY
Intended journal or grant mechanism *
IMPORTANT: Before submitting the form please print the form and save it as a PDF for your own records.
Thank you for collaborating in the FLASH research group. If you have any additional questions please contact Veronika Lesiuk at flashcalpoly@gmail.com 
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms