Today M-D-Y
First Name:
Last Name:
Post-Nominal Letters (e.g., PhD, MD, PharmD, etc.):
Personal Email Address:
First Name:
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Last Name:
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Post-nominal letters:(e.g., PhD, MD, PharmD, etc.)
Personal Email Address:
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Hire date:
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Today M-D-Y
Most recent date (Onboarding vs Hire date)
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Academic Title:
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Assistant Professor
Associate Professor
Professor
Other
Other academic title:
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College:
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Arts and Science Dentistry Engineering Medicine Nursing Pharmacy Public Health Vet Med Other
Other college:
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Department:
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Biological Chemistry and Pharmacology Biomedical Informatics Cancer Biology and Genetics Department of Biomedical Education and Anatomy Microbial Infection and Immunity Molecular Medicine and Therapeutics Neuroscience Physiology and Cell Biology Anesthesiology Dermatology Emergency Medicine Family and Community Medicine Internal Medicine Neurology Neurological Surgery Obstetrics and Gynecology Ophthalmology Otolaryngology Orthopaedics Pathology Pediatrics Physical Medicine and Rehabilitation Plastic and Reconstructive Surgery Psychiatry and Behavioral Health Radiation Oncology Radiology Surgery Urology Other
Division:
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Division of Biomedical Education Center for Bioethics/Division of Bioethics Division of Anatomy
Division:
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Cardiovascular Medicine Division of Hematology Division of Oncology Endocrinology, Diabetes and Metabolism Gastroenterology, Hepatology and Nutrition General Internal Medicine Hospital Medicine Human Genetics Infectious Diseases Nephrology Palliative Care Pulmonary, Critical Care and Sleep Medicine Rheumatology and Immunology
Division:
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Cardiac Surgery Colon and Rectal General and Gastrointestinal Surgery Pediatric Surgery Surgical Oncology Thoracic Surgery Transplantation Surgery Trauma, Critical Care and Burn Vascular Diseases and Surgery
Disease specific research group (DSRG): Please select not applicable if you are a researcher working outside of these clinical DSRGs (for example, Population Sciences).
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Acute Leukemia Bone Marrow Transplant (BMT) Breast Chronic Lymphocytic Leukemia (CLL) Central Nervous System (CNS) Gastrointestinal (GI) Genitourinary (GU) Gynecologic Head and Neck Lymphoma Melanoma Myeloma Sarcoma Thoracic Thyroid/Neuroendocrine Not Applicable
Administrative Assistant, if applicable: We will work with this individual to schedule introductory meetings.
First Name:
Last Name:
Admin Email Address:
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Select your role.Choose one or both so that we can connect you with helpful resources.
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Are you a basic or translational researcher who will be conducting research from a wet lab?
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Yes
No
Will you need biobanking services?
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Yes
No
Will you be using animals at OSUCCC for research?
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Yes
No
Will you be importing animals from your previous institution?
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Yes
No
Do you need separate computational space?
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Yes
No
Do you need computational space for your research group?
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Yes
No
Will you need access to clinical data or images for your research?
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Yes
No
Will you require human biospecimens for your research?
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Yes
No
Will you need to order lab supplies or equipment?
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Yes
No
Will you be enrolling patients to clinical trials?
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Yes
No
Yes
No
Does your research require large scale data storage and/or high-performance computing?
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Yes
No
Please indicate what is needed.
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Are you bringing data with you?
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Yes
No
Are you planning to bring any computers?
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Yes
No
Did you receive OSUCCC startup funds?
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Yes
No
Would you like assistance managing your startup funds?
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Yes
No
Will you be using startup funds to hire PhDs, post docs, staff or students in your lab?
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Yes
No
Do you anticipate developing/submitting a programmatic grant application in the next 3 years?(i.e. P01, U54, U24 or SPORE etc.)
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Yes
No
Are you interested in pursuing funding from industry or private foundations, external grants (through the NIH or other federal grants), and/or internal OSU funding streams?
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Yes
No
Are you interested in mentoring trainees in your research group?
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Yes
No
What level of trainee would you be interested in mentoring? Please select all that apply.
Would you like the opportunity to connect one-on-one with an established researcher to discuss your career path and/or to connect with a mentor in your research area within the CCC?
Topic examples include shared personal and/or professional background, an insider view of NIH, promotion and tenure, seed grants.
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Yes
No
Please upload your CV.
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Ryan Edwards (Director, Facilities and CCC Membership)
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Judy Hickman-Davis (Interim Senior Director, Animal Care and Use Program)
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Scott Harris (Assistant Director, Information Technology)
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Nancy Single, PhD (Director, Clinical Research Operations)
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Stacey Hanel (Interim Finance Director), Lisa Diaz Laredo (Purchasing Manager)
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Steve Edwards (Finance Director) or Stacey Hanel (Interim Finance Director), Lisa Diaz Laredo (Purchasing Manager)
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Angela Campbell (Senior Director, Clinical Trials Office), Kristy Humphries, (Director, Clinical Trials Office), and John Hays PhD, MD (Medical Director, Clinical Trials)
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Faith Kline, PhD (Director, Shared Resources)
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Jennifer Viernes (CCC HR Consultant)
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Li Zheng (Director, Grants Administration), Catherine Hunt, PhD (Director, OSU Foundation Relations), Julie Breckenridge (Program Manager, Intramural Research Program)
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Kellee Gauthier (Senior Director, Education, Training and Growth)
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Belkis Clark (Program Director, Career Pathways)
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Kellee Gauthier (Senior Director, Education, Training and Growth)
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Rebecca Peterson (Senior Director, Strategic Initiatives)
Ted Yank (Director, Research Administration)
Kellee Gauthier (Senior Director, Education, Training and Growth)
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Onboarding checklist completed form
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