Summary of Your Research Project Contact Information for Principal Investigator First name Last name Email* Telephone number* Primary affiliation* —Please choose an option—Horizon Health NetworkRéseau de santé vitalitéUniversity of New BrunswickDalhousie Medicine New BrunswickDalhousie MedicineNew Brunswick Community CollegeMount Allison UniversitySt. Thomas UniversityOther Faculty/Department Research Team Members Names of team members Are any team members: Patients?Caregivers?Family members? Is this a student or resident project? YesNo Under which program? —Please choose an option—Research in Medicine (RIM)Medical residentPharmacy residentGraduate student(Master's, PhD)Other Who is their supervisor or mentor? Summary of your research project Project title Project summary Please provide a brief, plain language project summary, including its objectives and potential significance (word limit: 250 words) Current Project Status Does your project have institutional approval from Horizon? YesNo What is Your ROMEO File Number? Is your project funded? YesNo What is the primary purpose of your project? How can Research Services help you? Research logic and planningMethods and study designSample size and powerGrant/proposal preparationData collectionData file organizationAccess to administrative dataStatistical design, analysis and interpretationKnowledge translation (e.g., manuscript, poster)Patient/community engagementOther Proposed start date Proposed end date Research Project Information Please attach any of the following supported documents. Draft Research Protocol Copy of Other Institutions' REB Approval Journal Articles (Reference)