Prov/Bos CFAR IS SWG Consulting Form

First Name: *

Last Name: *

Institutional Email address *

What is the purpose of your consult request? *

Writing a research question	Guidance on a project design/grant writing
Guidance on evaluation design	Other

If other, please describe below:

Please specify what you are requesting assistance on (e.g., framework selection, specify which aims you would like to discuss, interview guide development, etc.) *

What is the stage of your project? *

Do you intend to submit a grant for this project? *

Yes

No

If yes, what is the intended timeline for grant submission?

Are you looking for an Implementation science collaborator or someone with methodological expertise for your proposal? *

IS collaborator

Methodological expertise

Not looking for a collaborator

Please provide additional information as able regarding your above choice

Please upload any specific aims or existing grant documents here so we can best prepare for our meeting

Conceptualization	Grant writing
Implementation	Data Analysis
Manuscript writing