Stony Brook University QI/Program Evaluation Self-Certification Tool

This is survey number: 268

Email:

Name of project lead

Project title (If this is a change to your original project please add "change to project" after the title)

Brief description of project goals

Upload the Application for Designation of Activity as Quality Assurance/Quality Improvement

Upload any data collection tools you will be using for your project

Department through which the project will be conducted

Confirm that you have met the Quality Improvement training requirement by viewing the video embedded on the QI Training Requirements page: (https://www.stonybrook.edu/commcms/research-compliance/Quality-Improvement/Training).

I have met the Quality Improvement training requirement

Click to write the question text

Click to write Choice 1
Click to write Choice 2
Click to write Choice 3

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Click to write Choice 2
Click to write Choice 3

Will the project involve testing an experimental drug, device (including medical software or assays), or biologic?

Yes
No

Has this project received funding (e.g., federal, industry) to be conducted as human subject research?

Yes
No

Is this a multi-site project? (e.g. there is a coordinating or lead center, more than one site participating, and/or a study-wide protocol)

Yes
No

Is this a systematic investigation designed to contribute to generalizable knowledge? (e.g., testing a hypothesis; randomization of subjects)

Yes
No

Will the results of the project be published, presented or disseminated outside of the institution conducting it?

Yes
No