InciSioN Direct National Working Group Research Collaboration Interest Form
Dear Future Collaborator:
Please complete this form to facilitate the initiation of your research collaborations with specific National Working Group(s) of the International Student Surgical Network (InciSioN). All communications regarding this collaboration and information provided by you, will be kept confidential by our team. The National Working Group leader(s) will contact you shortly after the submission of this form to schedule a call.Please feel free to contact us directly with any questions via:

Thank you for your interest in collaborating with InciSioN,

The InciSioN Research Team
First Name, Last Name, Title, Affiliation: *
E-mail address: *
Title/Topic of the study: *
Which area of Global Surgery will this research be focusing on: ( Please mark all that apply) *
What study design will this collaboration entail ( Please Mark all that apply):
What type of Data collection will this collaboration involve? *
In addition to InciSioN, what other entities will be part of this possible collaboration? *
Please provide a synopsis of the research collaboration you have in mind: *
What do you hope to achieve from this collaboration for you/your organization? *
What role do you envision InciSioN will play in this collaboration? *
What opportunities do you envision this collaboration will provide for Medical Students, Trainees and early career physicians? *
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