PERT Intake Form

To submit your study for PERT review and collaboration, please complete the information requested below.

Type of study
Is this a multi-centre study?
Is this a PERC approved study?
Is Health Canada approval required?
Has Health Canada approval been obtained?
PERT Research Nurses required
PEMRAP required
Services requested
Stage of Project
How many years of a budget attributed to PERT?
Please attach any relevant study material (Protocol, Budget, Case Report Forms, Standard Operating Procedures etc.) as 1 file only
One file only.
100 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods.

Collection of personal information
Your personal information is collected under the authority of section 33(c) of the Freedom of Information and Protection of Privacy Act. If you have any questions about the collection or use of this information, please visit our Access to Information page.