The NIHR Research Design Service for the East of England
Client Enquiry Form

Please complete this form to access specialist research advice in the East of England.

Your Details

Title:


Name:


Other Name(s):

Profession: 


Work E-mail:


Alternative E-mail:


Work Telephone:
 


Other Number:

 

Employer Details

Trust/Organisation Name and Address:

Sector: 


Employing Organisation:

Project Details

Type of advice required: 

Project Title (if known):  


Name and Job Title of Principle Investigator: 


Please give brief details of the project: 

Please give details of any patient and public involvement (if any):

 

Grant Application details (if known)


Funding Stream:  

Amount Applied for £:


Have you contacted your Research & Governance Department (if applicable)?: 
 

Future Research

The RDS-EoE endeavour to capture details of those interested in further research.  If you are happy for your details to be held this way, please select your areas of interest below:

Age and Ageing Blood Cancer
Cardiovascular Congenital Disorders Dermatology
Dementia/Neurodegenerative Diseases Diabetes  ENT
Education Falls Prevention Health Related Behaviour
Inflammatory & Immune System  Injury and accidents Infection
Mental Health Metabolic and Endocrine Medicine for Children
Musculoskeletal Organisation and Management of Services Ophthalmology 
Oral and Gastrointestinal Patient/Practitioner Interactions Public Health
Renal and Urogenital Reproductive Health and Childbirth Respiratory
Sexual Health Skin Stroke 
 Other (please specify): 

Please tick here if you would you like to be added to our mailing list and receive the NIHR RDS EoE Quarterly Bulletin? 

Thank you for your time. 


Please note that the personal data collected by the RDS-EoE will be processed in line with the UK Data Protection Act 1998.

 

 

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