Research and Treatment Application Order Number Contact Information First Name * Last Name * Email Address * Contact Number * Affiliation: * If a Kadiant team member, please list your supervisor: If a Kadiant team member, please list your assigned division: Proposal Information Title of the project: * Geographic location for research: * Necessary age range of client: * Research topic: * Anticipated start date: * Specific diagnosis of client: * This is an application for (select one): * Research Study: any project developed for the purposes of answering a knowledge gap in the relevant literature (e.g., theses and Dissertations) Treatment Evaluation: any project intended to assess the effectiveness of a specific treatment or identify the most effective treatment for a client. If this is a research study, select the one that applies: University-Sponsored: Research projects conducted by a researcher, faculty member, or student completing a thesis or dissertation requirement Kadiant-Initiated: Research projects conducted by Kadiant employees for the purposes of dissemination (e.g., publication) Document(s) Upload 1. Purpose and Objectives of the Research/Evaluation 2. Research/Evaluation Main Question(s) 3. Methodology a. Experimental Design and Conditions b. Number of participants and specific characteristics c. Dependent Measures and Method of Data Collection 4. Potential Benefits 5. Methods for maintaining confidentiality of participants 6. Method for storing and destroying data 7. Approvals a. If this is University-Sponsored Research, include the IRB approval letter b. If this is Kadiant-Initiated Research, include information on applicant’s qualifications and a list of possible outside collaborators. c. If this is a Treatment-Evaluation, include approval letter or email from clinical supervisor 8. Participant Recruitment Flyer
