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Health System Strengthening
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Statistics and Data Support
Swiss Centre for International Health

Registration for Statistics and Data Support

First name:

*

Surname:

*

E-Mail:

*

Phone:

*

Name and e-mail of the supervisor, where appropriate (compulsory for dissertations):

INFORMATION ON THE PROJECT

Project name:

*

TYPE OF PROJECT (please check those that apply)

Observational study

Clinical trial

Experimental study

Other

If other, please specify:

PURPOSE OF THE PROJECT (several choices possible):

Dissertation

Publication

Research proposal

Proposal to Ethics Review Board

Other

Short project description:

*

The following questions will help to make the first meeting more effective

Support needed for:

Study design (including power calculations)

Data management

Data analysis

Database design

Interpretation of results

Editorial support

Software development

Other

If other, please specify:

Have you had support from the BCS-Unit before ?

Have you had support from the BCS-Unit before ?Yes
No

By whom ?

If necessary, services can be billed to an internal project account of Swiss TPH:

If necessary, services can be billed to an internal project account of Swiss TPH:Yes
No

Account # or unit:

Additional information or comments:

I confirm the correctness of the above information *