Associate PI Scheme - Applicant Registration Form
This form should be completed by applicants wishing to register for the Associate PI scheme which has been endorsed by the NIHR Clinical Research Network (Cancer, Surgery and Oral & Dental Specialty Cluster) and the Royal College of Surgeons (England) as set out in the Scheme Overview (https://docs.google.com/document/d/1ytcSsOVNZUajnTJbuGryvfcSxYJJhL3eHbD6LEamHYE/edit#heading=h.gjdgxs).

Applicants may only register for the Associate PI scheme to work on a study which has been registered by the Chief Investigator and Clinical Trials Unit for the scheme. A list of registered studies can be found on the NIHR's website https://www.nihr.ac.uk/explore-nihr/specialties/surgery.htm


The online form for registering a study for the scheme can be found at the following link: https://docs.google.com/forms/d/e/1FAIpQLScdYW2qyKv-OtBSfkAD3psY_Ab0426sZIETeumtSptnjBFQzw/viewform.
Email address *
Applicant Name *
Your answer
Applicant Email Address *
Your answer
Applicant Role *
Please specify your current post and Specialty.
Your answer
Study Name *
Your answer
CPMS Study ID *
CPMS IDs can be found on the list of registered studies at the following link: https://www.nihr.ac.uk/explore-nihr/specialties/surgery.htm
Your answer
Site where applicant is based *
Please provide full name of site and trust including postcode
Your answer
Site Principal Investigator *
Your answer
Site Principal Investigator Email Address *
Your answer
Name of Clinical Trials Unit *
This could be a registered Clinical Trials Unit or an equivalent organisation that is responsible for the management of the study.
Your answer
Name of Study Coordinator / Trial Manager *
Your answer
Study Coordinator / Trial Manager Email *
Your answer
Please tick the box below to confirm that the Principal Investigator and Study Coordinator / Trial Manager have agreed to you being registered for the Associate PI scheme for the study and site listed above. *
Required
Please confirm that you agree to complete the Associate PI Checklist (https://docs.google.com/a/nihr.ac.uk/document/d/12GQC3qLWizrAJj4wWlZw5oc0UCYdhPvR86TcQIr0zBs/edit?usp=sharing) during your involvement in the study and once all the relevant criteria have been met, will forward the checklist to the PI and Study Coordinator / Trial Manager for confirmation and signature. *
Required
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