CSC/Surgery Consultation Request Form
Please read our Standard Operating Procedures (SOP) before submitting your form. A consultation request should be submitted for each new project. To schedule a meeting for current projects, please contact your project statistician directly.

Please fill out the form with as much detail as possible. The more detail you provide, the more productive the initial meeting will be. A confirmation email will notify you that the request was received, and a statistician will reach out to you. Please allow 2-3 business days for a response to your request.

Important: Most projects require 6 weeks notice prior to the requested final deadline. If your project has an earlier deadline (e.g. less than 6 weeks from the date of the initial request for consultation), we encourage you to still submit a request below, but please note that we may be unable to accommodate earlier deadlines. You will be contacted within 2-3 business days to discuss the details and other possible options.

All submissions will automatically receive a confirmation email with a copy of their responses. If you do not receive the email within a few minutes, it's possible that your request was not received on our end (please resubmit). Please email us at statconsulting@uci.edu if you have problems submitting.
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Email *
First Name
 *
Last Name
 *
Phone Number
 *
Attending or Project Supervisor Name
 *
Attending or Project Supervisor Email
 *
Project Title
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Main Research Question
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Hypotheses
The next three questions ask you to list your hypotheses. You must list at least one, and may list up to three.
Hypothesis 1
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Hypothesis 2
Hypothesis 3
Project Type
Check all that apply.
*
Note: Modification of a previously completed analysis applies ONLY if there is a clear break between the original analysis and the modifications, e.g. two different targets for submission.
Required
Data Source
A data source is needed for any type of statistical analysis planning or implementation of analysis for existing data. A data source is not needed for, e.g., statistical assistance with IRB or design of a study in which new data will be collected.

If you are using an existing data source or providing data to the statistician, you MUST include a data dictionary or codebook. Data that has not been adequately formatted and cleaned in preparation for data analysis will delay completion of the project.
Indicate the expected data source. Select "N/A" if a data source is not needed. Select "Other" for other reasons and provide a brief description.

Select only one.
*
Specify the data source:

Select only one.
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Is this project related to a grant? The CSC may request additional follow-up information about awarded and new grants.

Select only one.
*
Target for Submission
The following two questions ask you to select the general target for submission and then to name the specific target. The name of the specific target depends on the general target. Please see below.
General Target for Submission

Select only one.
*
If you selected "Abstract or poster for a conference", name the conference. If you selected "Manuscript for journal", name the journal. If you selected "Grant application", name the granting agency.
Submission Deadline
The following questions ask about the submission deadline, set by the conference/journal/grant/etc., or the target submission date. First, indicate whether the submission deadline is absolute or rolling. If the submission deadline is absolute, then specify a date.
Type of Submission Deadline

Select only one.
*
If there is an absolute deadline set by the conference/journal/grant/etc., or target submission date, indicate the date below.
MM
/
DD
/
YYYY
The date ahead of the submission deadline that gives you adequate time to ask questions, request modifications, integrate the statistics with other elements of the submission, circulate results among a group of authors, etc.
*
MM
/
DD
/
YYYY
Comments
A copy of your responses will be emailed to the address you provided.
Submit
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