Project Intake - George & Fay Yee Centre for Healthcare Innovation

Fill out this form to request support and/or services from CHI.


Organization Name and Address


*Email Address

*Phone Number

*Please provide a BRIEF SYNOPSIS of the project which should include the following:

  • Title of the project
  • Purpose of the proposal
  • Hypothesis to be tested, or the research question to be answered
  • Objectives to be achieved and approach or study design proposed
  • Progress made to date

*Please indicate the services or support you think you need assistance with:

Any additional comments

Powered by SimpleSurvey