Request edit access
NOSM U PGME- Request for Access to Residents for Research Purposes
Associated policy can be found on our Policy & Procedures site 
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Email *
Date of request *
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By when are you hoping to have this circulated? 
(Note: This request may take up to 20 business days for review and approval)
*
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Title of Research Project *
Name of researcher(s) involved *
Name of affiliated organization(s) involved in research *
Type of research study *
Please identify your intended participants (is there a specific discipline, year you are wishing to target in this study)? *
Intended audience for research *
Research Ethics Board Approval has been obtained *
REB* Approval date 
(*Approved REB & any associated documentation should be submitted to postgrad@nosm.ca as part of approval review)
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Have you obtained any additional required institutional approvals? (e.g. biosafety)

Note: Please submit any copies of additional approvals to postgrad@nosm.ca as part of NOSM U PGME approval review 
Have you received any source of in-kind or actual funding for the research project? If so, please disclose and detail below.

As the requestor, I/We are advising of the following:

(Please select all that apply)
The following is a checklist of documents which must accompany this application and be sent directly to postgrad@nosm.ca :
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