Scholarly Activity - Initial Proposal

To proceed, you MUST have a signed faculty/department sponsor approval form.

Before completing this form, consider reviewing the scholarly activity planning sheets:

Case Report

Quality Improvement

Research Study

Last Name

First Name

Name of PI (if different than above)

Collaborators (if applicable)

Western Reserve Hospital staff members must use their employee email addresses. Medical students must use their school email addresses.

Employee Status

Project Aim

Project Status:

Scholarly Activity

For teachings/lectures (30min+), comprehensive literature reviews, and reports of clinical techniques, please select "Other."

Biostatistician Request

Check this box to request a consultation with the contracted biostatistician. This box should be selected for all original research studies at Western Reserve Hospital.

Faculty/Department Sponsor Name

For lectures (such as grand rounds), please enter the appropriate department.

Faculty/Department Sponsor - Approval Form

Please upload your SIGNED faculty/sponsor approval form.

For lectures/teachings (such as grand rounds), please upload supporting documentation (PowerPoint, etc.) in place of a signed faculty form.

Drop your files here

Identifying Title

Include a brief title that will allow you to differentiate between multiple submissions. This title is for identification purposes in Smartsheet only. It will not be the final title.

Send me a copy of my responses

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