HMRU Intake Form

Thank you for your interest in Cornell University’s Division of Nutritional Sciences Human Metabolic Research Unit (HMRU). The purpose of this Intake Form is to both help us gain an accurate sense of how researchers plan to use the HMRU, and also to help further your research objectives. You will be contacted after this form is reviewed. Thank you.

Your Email Address:

Your contact phone number(s):

Office

Mobile

Laboratory

Study Title:

Study Nickname (8 characters or less):

Proposed Start Date (MM/DD/YYYY):

IRB # and Title (if approved):

Target Journal for Submitting Research:

Funding Source (if N/A, see below:)

Account number to be charged for the study:

Rooms you wish to use (Check all that apply):

Name and Email for Students and Research Assistants who you intend to have assist with your experiment:

Thank you again for providing the above information. If you are not the faculty supervisor on this project, please remember to alert him/her/them that they will be receiving an email requesting that they verify the content of this intake form.