OCTRI BIOSTATISTICS REQUEST FORM
 This form will help the Biostatistics staff to understand your project’s needs.
 Complete this form.
 Attach your protocol or research plan. A draft research plan will help us triage your request.
 Send all documents to Biostatistics Resources bdp@ohsu.edu.
Or call us with questions at 503-418-9241.
Details
*Principal Investigator
Last Name
*Primary Contact Person
(if not the Principal Investigator)
First Name
Title
Email
Phone
eRA Commons ID  What’s this?
eRA Commons ID is only required for the PI.
Date this form was submitted
*Project Title:
Biostatistics Summary of Request
Please provide a description of the services that you are requesting from the biostatistics team in detail.
*Funding Type
Choose from Federal / Foundation / Industry / Internal / Unfunded or specify
Funding Status
Choose from Awarded / Submitted / Planned
*If Planned, Submission Due Date
Funding Source Sponser
(e.g. NIH, DOD, Gates Foundation, Payer Pharmaceuticals)
Federal Grant Type (if applicable)
(e.g. R01, K12, K23)
OCTRI Biostatistics Request Form 5/12, BDP@ohsu.edu
OCTRI BIOSTATISTICS REQUEST FORM
Mark X to
request.
OCTRI Biostatistics Research Services
Pre-Award Requests
Sample Size Power Analysis
Protocol Development
General Statistical Consultation
Grant Submission Assistance
Statistical Software Training
Grant Submission Services
Data Analysis
Data Management
General Statistical Consultation
Manuscript preparation & Review Services
Statistical Software Training
*Type of Study
Mark X for all
applicable.
Human Study
If human study, enter IRB information in the box below.
Child Health Study
HIV/AIDS Study
Animal Study
Non-Human Subjects Research
If animal study, provide IACUC number:
(Cells, tissues, data only)
Institution & IRB Information
* Mark X for all
applicable.
IRB #
(if available)
Number of
participants to
be enrolled
*Anticipated
study start
date
*Anticipated
study end
date
OHSU
VA
Kaiser Permanente
Other IRB/Institution (Specify):
OCTRI Biostatistics Request Form 5/12, BDP@ohsu.edu
OCTRI BIOSTATISTICS REQUEST FORM
Mark X to
request.
Other OCTRI Research Services
Compliance, Regulatory and Study Initiation Services
IRB Submission (OHSU IRB, VA IRB, Kaiser IRB) 
Regulatory Consultation : On topics like IND/IDE Submissions, Monitoring, DSMB Meetings, Other
regulatory issues)
Grant Submission Services
Data and Safety Monitoring Plan (DSMP) for grant submission 
Budget Development for grant submission 
OHSU Epic Data Query for count of potential research subjects
Consultation on Community Research and Identifying Community Partners
Participant-based Services (including Clinical & Translational Research Center)
ResearchMatch 
Inpatient or Outpatient Nursing 
Outpatient Room Only (without nursing services)
Study Coordinator Services 
Laboratory Services 
–Body
Sample
processing
Composition
and Energy Expenditure Measurements 
Research
Meals
or Regular Meals for study participants 
Assays and
Analysis
–– Resting
energy
expenditure by indirect calorimetry 
Bionutritionist Services 
–– Storage
Bod Podand
 Shipping
Data Analysis Services
–Statistical
Anthropometric
GeneticsMeasurements
Consultation 
Bioinformatics
Consultation
 technologies:
– DEXA
 any
This
includes
of the following
This includes any of the following technologies:
– Affymetrix: Microarrays, Exon arrays, miRNA arrays, SNP arrays
Bioelectrical
Impedance Analysis
 miRNA arrays, SNP arrays
–– Illumina:
Affymetrix:
Microarrays,
Exon arrays,
Microarrays, Genotyping arrays, Methylation
– Massively Parallel Sequencing
–– Proteomics,
Illumina: Microarrays,
Genotyping
arrays,
Methylation
Copy number variation,
Next Gen
Sequencing,
Expression and linkage analysis, Computational Biology
Manuscript Review 
– Massively Parallel Sequencing
Statistical Software Tutorials 
– Proteomics, Copy number variation, Next Gen Sequencing, Expression and linkage analysis,
Data Collection
& Management
Services
Computational
Biology
OHSU Epic Data Queries: De-identified data for retrospective analysis 
OHSU Epic Data Queries: De-identified counts for potential research subjects 
OHSU Epic Data Queries: Identified data for recruitment/data analysis 
Data Collection Tools
Survey Tools: Web-based System (REDCap) 
OCTRI Biostatistics Request Form 5/12, BDP@ohsu.edu
OCTRI BIOSTATISTICS REQUEST FORM
Mark X to
request.
Other OCTRI Research Services
Database Design
Web-based REDCap Database 
Custom Relational Database 
Community-Engaged Research
Identifying Community Collaborators 
Consultation on Community Research 
Conducting Research in Rural Settings (ORPRN) 
Epic data from Community Clinics (OCHIN) 
Biolibrary
OHSU Biospecimens 
 This form will help the Biostatistics staff understand your needs. All other OCTRI
requests will be routed to the Research Navigator Program staff to understand your
project’s additional needs and to guide you through the complete request process.

Send completed form and research plan to bdp@ohsu.edu.
Or call us with questions at 503-418-9241.
OCTRI Biostatistics Request Form 5/12, BDP@ohsu.edu