Center for Learning Health System Sciences (CLHSS) Service Request

Completion of this form is the first step of the CLHSS services request process. The request review process takes approximately 2-4 weeks. Requests for more information will follow the initial review. Questions? Email clhss@umn.edu.

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Project Details

Please provide the name and email address of the principal investigator for this project, if different from the person submitting this request.

Please provide the research question and/or what clinical care delivery problem you are trying to solve.

What are the anticipated key deliverables for this request?

What are the key outcomes or metrics that will be needed to know if you answer your research question or improve clinical or care delivery?

Are there any project deadlines (i.e. grant, manuscript, etc.) that we should be award of?

List other project collaborators that should be included on any project communication. Provide first and last name(s) and email address(es)):

Please attach any additional material that helps define the request, e.g. order sets, protocols, algorithms, etc.

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Service Request

Please select the CLHSS service(s) that you need for your project below. Please note that we are an internal service organization and there maybe a fee associated with the service(s) you request.


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