Online Research Profile Form

Online Research Profile Search Form

The ADRFA office is working to provide a way for like minds to connect. We ask that this questionnaire be filled out so that we may create a database to assist in collaboration among researchers and students at SIU-SOM. It is our hope that those who comprise the research team at the School of Medicine will take the short amount of time required to fill out this questionnaire as the usefulness of this tool is dependant on participation. When completing this form, limit the use of acronyms only to those that are well established in the field. Do not use abbreviations or symbols. Please spell them out.

Name:
Department/Division:
Office Location:
Office Phone Number:
Email Address:
Location of Laboratory:
Laboratory Phone Number:
Are you willing to mentor medical students and / or residents?	Yes No
Research Interests: (Limit each entry to 15 words or less, and include as many unique "keywords" as you can for each entry.)
Additional Keywords: (Provide up to 10 keywords that are not included in the research interests (above) or grant titles (below).)
Techniques and Methodologies: (List the methods used in your research.)
Equipment and Software: (List major pieces of equipment and research software available in your laboratory)
Current Collaborators: (List coinvestigators and other key personnel.)
Current and Pending Awards: (List all grants (including clinical trials) under the separate categories of "Current" and "Pending". For each grant, include its title, your role on the grant, and the awarding agency).
Publications: (List up to 10 representative publications. Include PubMed references if available.)
Optional: (Provide web address for CV)