CRSO Research Staffing Core

Staffing Request Intake Form

Please have all information available to complete the form at the same time. The Form cannot be partially completed and saved.

Requestor Information Section

Today's Date

mm/dd/yyyy

Requestor Name (First & Last)

Job Title/Role

Name of PI if Different from Above (First & Last)

Department / Division

Request For

Staff

Information about Staffing Core

Have you used the CRSO Research Staffing Core before?

Yes

How did you hear about the CRSO Research Staffing Core?

Study Information Section

Will this staff work on multiple studies?

Yes

Unknown

Are any of these studies greater than minimal risk?

Yes

Does this study/studies involve an investigational drug or device?

Yes

Funding Source Information Section

What is your funding source?

Are funds currently available to support this staff?

Yes

Please provide brief information related to the funding source

Staff Needs Section

What level of staff are you requesting?

What tasks will you need staff to complete?

What % effort do you anticipate needing?

What is your required timeframe for staff support?

Do you know the Anticipated Start Date for Staff?

Yes

Staff Need Duration

Short term need (< 6 months)

Long term need

Send me a copy of my responses

Requestor Information Section