Application to Access Biospecimens

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PROPOSAL INSTRUCTIONS & REQUIREMENTS

Submit your application to access PNRR biospecimens by completing this survey. You will be asked to provide the following:

Investigator Information
Sample/Data Request Overview
Research Plan (two page maximum)
Literature Citations (two page maximum)
Personnel Information
- Biographical Sketches for PI, Co-PI and/or Collaborators (two page maximum per investigator)
- Letters of Collaboration

Should your application be approved by the Foundation for Peripheral Neuropathy (FPN) Scientific Advisory Committee, you will be required, as set forth in the Data Use Policy, to execute a Data Use Agreement with FPN and a Materials Transfer Agreement with the University of Indiana, which maintains the PNRR on behalf of FPN.

Download this file to review the PNRR Data Use Policy and the SOP for reviewing sample applications prior to submitting your application.

Attachment:Data Use Policy and Request Review SOP.pdf

Date

M-D-Y H:M

Principal Investigator's First Name

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Principal Investigator's Last Name

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Suffix

Email Address

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Institution

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Legal Address of Institution

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Project Title

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Institutional Tax Status

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Will you request (or have you already received) IRB approval for your study?

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Please attach the approval or exempt status memo from your IRB here.

Upload file

What would you like to request?

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The catalog of specimens available can be found online at https://thepnrr.org/. If you have additional questions about the specimens or subject clinical characteristics, please email pnrr@iupui.edu.

Which sample type(s) are you requesting?

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DNA

Plasma

Serum

DNA - From how many subjects?

DNA - How much DNA (per subject) do you require?

Plasma - From how many subjects?

Plasma - How much plasma (per subject) do you require?

Serum - From how many subjects?

Serum - How much serum (per subject) do you require?

Briefly outline any additional parameters or subject characteristics (e.g. painful diabetic neuropathy, age range, etc.).

* must provide value

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If you would like to request samples from specific subjects in the catalog, please export that list from the catalog and upload the file here.

Upload file

You can download the data dictionary with the complete list of fields collected by the registry here.

Attachment:PNRR_Data_Dictionary.xlsx

Briefly outline the data variables you would like to request.

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If individuals other than the PI will have access to the data, please list those individuals and their role on the proposed project.

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Use the following application fields to create an executive summary of your research plan. Please limit each section of your application to less than 500 words.

References are optional (upload link provided below) and must be limited to two pages.

Briefly describe the study proposed and the rationale for these analyses, including the significance of both the study question and the specific project.

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Include a clear justification for the number and types of samples requested.

If results from the proposed study will be combined with those obtained from other samples, include an explanation of how the requested samples will fit in with the overall study design.

* must provide value

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Define the study hypothesis and describe the study design, including methods that will be used to test it.

Describe the specific procedures by which the samples will be tested and analyzed, including relevant data or citations demonstrating experience with these techniques.

Outline the power of the proposed study and anticipated size of a detectable effect.

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Investigators who are approved to access samples will be required to submit a report of completed analyses to the Foundation for Peripheral Neuropathy (FPN) through the PNRR. FPN reserves the right to deposit these analyses in a platform of FPN's choosing for use by the research committee 90 days after publication.

Describe what data and results will be returned to FPN and specify timelines for project completion and submission.

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Explain how a successful outcome of the proposed plan would lead to better understanding of peripheral neuropathy and/or would address critical questions essential to development of peripheral neuropathy therapies or biomarkers.

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Indicate whether there is current funding to support the research project and, if so, provide the funding source(s) and grant number(s). If there is no funding, briefly describe the plan to apply for funding.

Approval of access to samples will be conditional on successfully obtaining funding. Conditional approvals will be valid for a period of up to 9 months.

* must provide value

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Literature Citations

Upload file

Biographical Sketch - Principal Investigator

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Biographical Sketch - Co-Investigator (if applicable)

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Biographical Sketch - 2nd Co-Investigator (if applicable)

Upload file

Letters of Collaboration (if applicable)

Upload file

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