PeDRA Study Application InstructionsComplete the following application for your study to be considered as a PeDRA Study. PeDRA Studies receive many benefits, including centralized project support, eligibility to apply for Study Support Grants, and being featured on the PeDRA website. The extent of benefits provided may vary according to the nature and scope of each study. Applications will be reviewed by the PeDRA Studies Committee on a rolling basis and outcomes shared within approximately 6 weeks. Eligibility1. Study must be overseen by an Active Member of PeDRA (the principal investigator) working in collaboration with at least one other investigator. Other investigator(s) need not be active PeDRA members.2. Study must be relevant to the field of pediatric dermatology.3. Investigators may reside at either the same institution or at different institutions. However, at least one investigator must reside at an institution within the United States, Canada, or Mexico.4. The same individual may submit an application on behalf of multiple studies, but only one application is allowed per study. 5. Principal investigator must agree to ongoing communication with PeDRA via periodic phone calls and/or email. 6. Principal investigator must agree to acknowledge PeDRA on all publications and presentations resulting from the study. Principal (Corresponding) Investigator First Name Last Name Degree(s) Email Primary Affiliation Is the Principal Investigator an Active Member of PeDRA?YesNo Study Information Title Subject Area (select all that apply)Acne & HSAtopic Dermatitis & PsoriasisBirthmarksConnective Tissue & Autoinflammatory Drugs & BugsGenetic Skin Disorders (includes Down Syndrome)Hair DisordersNeonatal SkinSkin of Color & Pigmentary DisordersSkin Tumors and Reactions to Cancer TherapiesOther/Not sure Study StatusNew study Ongoing studyOther / Not sure Is your study already considered a PeDRA Study? YesNoNot sure Please provide any additional information on the study status here: Study Hypothesis (50 word max) Study Overview (250 word max) Estimated Budget (USD) - please indicate if you aren't sure Estimated study duration (in months) - please indicate if you aren't sure Anticipated funding sources Co-Investigators Please list all co-investigators working with you on the study. It's okay to provide only first and last name of each co-investigator. PeDRA may contact you for additional details later. Co-Investigator 1 First Last Degree(s) Affiliation Check here to add another investigator Co-Investigator 2 First Last Degree(s) Affiliation Check here to add another investigator Co-Investigator 3 First Last Degree(s) Affiliation Check here to add another investigator Co-Investigator 4 First Last Degree(s) Affiliation Check here to add another investigator Co-Investigator 5 First Last Degree(s) Affiliation Check here to add another investigator Co-Investigator 6 First Last Degree(s) Affiliation Check here to add another investigator Co-Investigator 7 First Last Degree(s) Affiliation Check here to add another investigator Co-Investigator 8 First Last Degree(s) Affiliation Check here to add another investigator Co-Investigator 9 First Last Degree(s) Affiliation Check here to add another investigator Co-Investigator 10 First Last Degree(s) Affiliation Check here to add another investigator Co-Investigator 11 First Last Degree(s) Affiliation Check here to add another investigator Co-Investigator 12 First Last Degree(s) Affiliation To include more than twelve co-investigators, please send the list of additional investigators by email to info@pedraresearch.org referencing your study title and primary investigator name. PeDRA Support Please indicate which PeDRA support services you are, or may be, interested in (select all that apply) Connections with collaborators Central project coordination Site recruitment Patient recruitment Statistics funding and/or support Publication funding and/or support Start-up support Regulatory support Communication/dissemination Other Please indicate other support services you are interested in: Contact Information