UChicago Practice-Based Research Network

UC-PBRN Intake Form

The UC-PBRN Intake Form is the first step in initiating a research partnership with our network. This brief form helps us understand your project needs, assess alignment with our clinical partners, and determine how we can best support your study. Please note that completing the intake form is required before submitting a grant proposal involving PBRN resources. Submission of the form at least 30 days before your grant deadline is required to allow time for committee review and response. If you have questions or would like to request a consultation before submitting your form, please contact us.

Click the link below to access the secure REDCap page where you can complete and submit your form.

Access the Intake Form on REDCap