PI Waiver Intake Form

Note: PI Waiver Requests are due 4 weeks before the proposal's due date. *Remember to include ALL ATTACHMENTS for your waiver type. Incomplete packets will be returned for corrections.

Learn more about School of Medicine proposal preparation & submission timeline: https://tinyurl.com/rmgprocess

*If this funding is a University Research Award (URA), no PI waiver is required at time of application. Please do not submit a waiver request.*

Questions? Contact Danny Sierra (dmsierra@stanford.edu) or another member of the Pediatrics Research Development Office for questions and to assess eligibility for specific PI Waivers: https://tinyurl.com/pedsRDT

Date you began working on this PI Waiver

mm/dd/yyyy

PIF, SPO, or RRA #

If there is currently no PIF/SPO/RRA, please enter "N/A"

Name of Individual Completing This Form (Last, First)

Applicant's First Name:

Applicant's Last Name:

Applicant's Stanford Email:

Applicant's Division in Pediatrics:

Note: The Applicant's Division Chief, Division Manager, and/or other relevant Division staff will be emailed a copy of this request.

Applicant's Current Career Stage:

PI Waiver Type

Review the School of Medicine policies on PI Waivers carefully and download the relevant PI Waiver template: https://tinyurl.com/piwaiver. Please select the type that matches the template you're submitting.

Is this waiver for an industry-sponsored clinical trial?

Yes

Details

Describe need for a PI Waiver

List the sponsor and Funding Opportunity Announcement (FOA) number as well as include a link to the website. Or describe the need for a Data Use Agreement here.

When is the PI waiver due?

Learn more about the School of Medicine internal 5-business day or 3-business day deadline for external proposals: https://tinyurl.com/rmgdeadline. If you need a PI waiver for a sponsored research project, indicate the due date here.

mm/dd/yyyy

Is an institutional letter of support required too?

Yes

Unsure

If Awarded:

Start Date:

mm/dd/yyyy

End Date:

mm/dd/yyyy

Admin Email Address

The PI on this waiver application will receive a copy of the signed PI waiver after it has been signed by Mary Leonard. Please provide a second email for an admin in your division who should also receive a copy of the PI waiver.

Upload Complete PI Waiver Packet (Single PDF Document)

NEW: For all waivers except Industry-Sponsored Clinical Trials and DUA/MTAs, attach the single PDF waiver packet, including the unsigned PI Waiver and all required attachments (see waiver letter template for list of required documents).

An automatic email will be sent to your Division Chief or other Division designee requesting approval of your PI Waiver packet. Upon approval, the signed PI Waiver packet will be automatically sent to the Division's RPM. No need to send the packet to the RPM via email.

For Industry-Sponsored Clinical Trials and DUA/MTA waivers - Upon approval, the PI Waiver with the Department Chair (Mary Leonard) signature will be returned to you within 3 business days.

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