DUHS Nursing Project/Research Study Early Intake Form

All students, whether employees or not, need to submit this intake form if you plan to perform a project implementation, program evaluation, or research study within Duke Health.


You will receive information from our Department of Nursing Research and EBP within 1 week which will guide you through the processes involved to have your project or study approved.

Indicate the type of program you have enrolled in:


Indicate the University you are enrolled in

(NOTE: Duke University School of Nursing students may indicate DUSON)


Name of your faculty advisor for your project or study

When do you aim to start performing your project or enrolling research subjects?

Note: Round to the first of the month


When do you aim to graduate from your academic program?

Note: Round to the first of the month


Indicate which DUHS facility/entity you wish to perform your project/study; may check more than one


If you checked other for clinical site, please tell us where you aim to perform your project/study

Indicate the population service line that you aim to perform your project/study with; may check more than one


If you checked other for service line, please tell us more regarding service line interests

If known, list specific units/clinics you want to perform your project in


If you have been working with a specific units/clinic leaders, provide their name here

If you have identified a preceptor or mentor, provide name here

Project/Research Study Topic

Indicate if you have a chosen a topic for your project or study:

For those with a topic: Briefly describe your project or study in 1-2 sentences

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