Scheduling Time
To schedule time on the fMRI facility, fill out the form below or call Ms. Fran Bowker at the UMDNJ-NJMS Radiology Department, 973-972-7500.
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= required field.
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Your Name:
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Your E-Mail:
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Your Day Phone:
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Your Evening Phone:
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IRB Protocol Number #
First Choice Time Slot
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Date:
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Start Time:
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Minute
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Second Choice Time Slot
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Date:
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Year
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Start Time:
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Minute
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Duration:
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hours
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Principal Investigators
Co-Investigators
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Title of Research Project:
(must be the same as on the IRB approval form)
Performance Site:
UMDNJ/University Hospital 3t Facility
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IRB Approval Date:
Month
January
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Year
2002
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IRB Expiration Date:
Month
January
Febuary
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December
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Year
2002
2003
Additional Requests
The University Heights Center for Advanced Imaging
A joint venture of UMDNJ New Jersey Medical School and Rutgers-Newark
