ZOLL LifeVest Fellows Research Grant Process
ZOLL welcomes the opportunity to partner with fellows in training on research projects. Support for research
projects is available to General and Specialty Cardiology Fellows. This document describes the ZOLL Fellows
Research Grant request process.
How to Request a Research Grant
1. Fellows in Training may submit requests to ZOLL for support of research projects by completing this “Fellows
Research Grant Request Form.”
2. Careful attention to documenting all aspects of the research project is important when submitting a request.
3. Grant requests are reviewed MONTHLY by ZOLL for consideration. Grant requests must be received by the 1st
day of the Month in order to be considered in that month’s review.
4. Data Use Agreement forms are required for all grant applications requesting the use of data from the ZOLL
LifeVest database.
5. Notification of application approval or denial will be communicated within 90 days of submission.
6. If approved, a Data Use Agreement form will be required to be completed.
Guidelines for Submissions
Research projects should generally be related to the role of Wearable Cardioverter Defibrillator (WCD) therapy and
Sudden Cardiac Death (SCD) risk and prevention.
It will not be possible for ZOLL to approval all requests for grant funding and requests will be approved based upon
novelty of the research proposal, alignment with ZOLL clinical research initiatives, and availability of funding.
Questions
For questions related to requesting a fellows research grant and to access the required forms, please visit
http://www.lifevest.zoll.com/fellows
For questions related to a submitted application, please contact: Grants@zoll.com.
Fellows Research Grant Application
Contact Information
Proposal Date: Click here to enter a date.
Investigator:
Institution:
Address:
City:
State:
Zip Code:
Phone:
Fax:
E-mail:
Fellowship Tenure: ☐1st year ☐2nd year ☐3rd year ☐Other (please describe)_________________
Subspecialty:
Faculty Sponsor: (required)
Institution:
Address:
City:
Phone:
Fax:
E-mail:
State:
Zip Code:
Proposed Study Title:
Click here to enter text.
Study Objectives:
Click here to enter text.
Study Background/
Rationale:
Include brief summary of
data from pertinent previous
studies if applicable.
Include justification for
control/comparator if
applicable.
Click here to enter text.
Study Design:
(check all that apply)
☐ Prospective
Brief Description of Study:
Click here to enter text.
Population:
Click here to enter text.
☐ Retrospective
☐ Other Specify: Click here to enter text.
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Sample Size:
Click here to enter text.
Key Inclusion Criteria:
Click here to enter text.
Key Exclusion Criteria:
Primary Endpoint:
Click here to enter text.
Click here to enter text.
Secondary Endpoints:
Click here to enter text.
Estimate of Key Timelines
Finalized study protocol:
weeks
IRB approval:
weeks
Enrollment timeframe:
weeks/months
Total length of study:
months/years
Potential Risks to Subjects:
Click here to enter text.
Describe Unique Informed
Consent Issues:
Click here to enter text.
Support Requested:
☐ Statistical analysis
☐ Data from ZOLL LifeVest databast (Data Use Agreement required)
☐ Abstract/Poster development
☐ Publication assistance*
* ZOLL authors will be included as contributing authors
☐ Financial -- provide detailed study budget, including patient level
costs, start-up costs, overhead, etc.
☐ Other (please specify)_____________________________________
Additional Financial Support:
Do you have other sources of financial support for this project?
☐ no ☐ yes  specify: Click here to enter text.
Will Additional Study
Centers Be Used:
☐ no ☐ yes  specify other institutions and primary investigators:
How Will Study Results Be
Presented?
☐ Publication  Proposed Journal:__________________
☐ Abstract/Poster  Proposed Medical
Conference:____________________________________
Medical Conference Submission deadline: Click here to enter a
Click here to enter text.
date.
Please attach clean, current copies of the following documents:
☐ Curriculum vitae
☐ Copy of State Medical License
SUBMIT COMPLETED APPLICATIONS TO: grants@zoll.com
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