PHHP Research Innovation Fund Form Name of Investigator(Required) First Last Email Address(Required) DepartmentBiostatisticsClinical & Health PsychologyEnvironmental & Global HealthEpidemiologyHealth Services Research, Management & PolicyOccupational TherapyPhysical TherapySpeech, Language & Hearing ServicesFaculty Rank(Required) Assistant Professor Associate Professor Professor Before moving forward, please read through the PHHP Research Innovation Fund Principles and Procedures.I have read through the PHHP Innovation Fund Principles and Procedures.(Required) Yes Please choose the theme that your proposal falls under.(Required) PHHP Research: General PHHP Research: Artificial Intelligence PHHP Research: Direct Clinical Impact Project Title:(Required) Please list any Co-Investigators and Affiliations(Required)Co-Investigator NameCo-Investigator Affiliation(s) Add RemovePlease include a 1-paragraph description of study/study goals.(Required)Please include specific aims that will be supported by this funding.(Required)What other funds are supporting your project? (e.g., PI IDCs, CTSI pilot, startup, etc.) Please be specific and include any cost-share agreements. (Note: any cost-share agreements listed are subject to verification.)(Required) Add RemovePlease include a BRIEF description of what you are requesting and how it will impact your goals.(Required)Total amount requested. (No more than $25,000)(Required) Please list each grant that you plan to submit based on this research. (Include planned date of submission for each grant.)(Required) Add RemovePlease upload the PI's NIH-style biosketch.(Required)Accepted file types: pdf, Max. file size: 125 MB.Please upload an NIH-style biosketch for any co-investigators involved with this request.(Required) Drop files here or Select files Accepted file types: pdf, Max. file size: 125 MB. Download a Basic Budget Template here.Please upload proposed budget for requested funds on the provided template.(Required)Accepted file types: xlsx, Max. file size: 125 MB.Please upload a brief budget justification.(Required)Accepted file types: pdf, Max. file size: 125 MB.