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Qualitative and Patient-Reported Outcomes Developing Shared Resource

If you are interested in utilizing the services of the Q-PRO Developing Shared Resource, please complete the Service Request Form below.

Name:          
 
Department:  
 
Phone Number: 
 
Is the study PI a Cancer Center member?  
 
Is the project cancer-focused? 
 
Project Title: 
 
Which of the services are you requesting?
             
Are the services for:
             
If "Grant Proposal Preparation" is selected, what is the grant due date?   [None] Select a Date Delete the Date
 
If "Grant Proposal Preparation" is selected, what is the anticipated start date of Q-PRO services?   [None] Select a Date Delete the Date
 
Funding Source/Anticipated Funding Source: 
 

Is the project funded?
                         
 Additional Notes:   

Quick Reference

Q-PRO Developing Shared Resource
Co-Director
Erin Sutfin

336-713-5282

esutfin@wakehealth.edu

Co-Director
Lynne Wagner

336-713-1478

lywagner@wakehealth.edu

Ways to Give
Six Wake Forest Baptist Specialties Earn U.S. News RankingsComprehensive Cancer Centers National Designation is Renewed2017-2018 Best DoctorsMagnet Hospital RecognitionJoint Commission Report

Disclaimer: The information on this website is for general informational purposes only and SHOULD NOT be relied upon as a substitute for sound professional medical advice, evaluation or care from your physician or other qualified health care provider.

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