Research Day

Student Research Day Application

PI (student) full name: 

Student phone number: 

Student email address: 

Mentor full name, title: 

Mentor email address: 

Approved by mentor? Yes   No

Category Clinical Vignette   Research  CQI

IRB Approval Yes  No  Filed / Pending

    IRB Approval # (if applicable) 

Status / Institution 

    Other (please explain, if applicable): 

Abstract

Title of Abstract

Authors (list PI first; separate authors with semicolon)

(Please type or copy/paste your abstract below or email it as an attachment to sresearchday@uicomp.uic.edu.)



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