This form is intended for students, investigators, faculty members, and project-associated researchers seeking approval for a publication, presentation, abstract, or ancillary study using RAHAT-related data or activities. Complete all applicable sections and provide enough detail for scientific and administrative review.
Fields marked with an asterisk (*) are required.
Date of request *
Name *
Email address *
Current organization *
Role *
Select one option. If you select Other, please specify your role.
Study PI or Co-ISite investigatorFaculty from a collaborating instituteMBBS student, including internPostgraduate studentProject-associated researcherOther
Please specify your role *
Type of submission *
Select all that apply only when every aspect of the proposal is the same.
PublicationPresentation or abstractAncillary study
Description * Provide one sentence describing your concept.
Target population *
Site-specificStudy-wide
Site name or names *
Additional investigators from the site List collaborating investigators from the site who helped with this proposal, in accordance with the applicable authorship and collaboration policy. Other investigators may be involved at a later stage.
Study or site investigator consulted * You are required to discuss your concept with any one study investigator or site investigator before submitting this form. Select an investigatorProf (Dr) Subrata Baidya - AGMCProf (Dr) Gajanan Velhal - BKLProf (Dr) Deepshikha Kamra - CMCProf (Dr) Chitra Ramesh - MMCProf (Dr) Sudha Ramalingam - PSGProf (Dr) Abhay Nirgude - YMC
Data needs *
Select all that apply.
New data collectionRequest for existing data for analysisOther
Please specify the other data requirement *
Background * Summarise the background in approximately 100 words.
Objectives *
Study design Maximum 200 words.
Population of interest List the inclusion and exclusion criteria that will be applied to reach the intended sample.
Follow-up time Define the start and end points.
Data and variables of interest * Define all variables clearly and address the categories below.
Outcomes *
Exposures *
Other variables
Timeline * State the expected duration of the project/analysis and the proposed submission timeline.
Alignment with RAHAT goals and objectives * Explain how the proposed work supports the scientific, educational, or implementation goals of RAHAT.
Potential journals in case of a publication List the journals currently being considered. This may be updated later.
Send me a copy of my responses.
I confirm that the information provided in this request is accurate to the best of my knowledge.
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