1 NCCOPR CCDR Registration

Conference, Meeting, Workshop, and Poster Session Registration Generic Clearance (OD)

NCORP CCDR Webinar Series - Registration Page

OMB: 0925-0740

Document [pdf]
Download: pdf | pdf
9/16/21, 1:24 PM

Collaborating to Develop New Practice Randomization Trials for NCORP CCDR Webinar Series

Collaborating to Develop New Practice
Randomization Trials for NCORP CCDR
Webinar Series
OMB No.: 0925-0740

Expiration Date: 07/31/2022

Public reporting burden for this collection of information is estimated to average 5 minutes
per response, including the time for reviewing instructions, searching existing data sources,
gathering and maintaining the data needed, and completing and reviewing the collection of
information. An agency may not conduct or sponsor, and a person is not required to respond
to, a collection of information unless it displays a currently valid OMB control number. Send
comments regarding this burden estimate or any other aspect of this collection of
information, including suggestions for reducing this burden to: NIH, Project Clearance Branch,
6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0740). Do not
return the completed form to this address.


1.

First Name

2.

Last Name

3.

NCORP Affiliation

https://docs.google.com/forms/d/1qbQkQYh6PDmW7Ydi5CGJ5V1vIQzNYUGma9uMWmEobck/edit

1/5

9/16/21, 1:24 PM

4.

Collaborating to Develop New Practice Randomization Trials for NCORP CCDR Webinar Series

Primary NCORP Role
Mark only one oval.
Clinical
Research
Administrative
Advocacy
NCI
Other:

5.

CCDR Relevant Role
Mark only one oval.
Research Base CCDR Lead
NCORP Site CCDR Lead
Study Lead
Statistician
NCI Staff
Other:

6.

Email

https://docs.google.com/forms/d/1qbQkQYh6PDmW7Ydi5CGJ5V1vIQzNYUGma9uMWmEobck/edit

2/5

9/16/21, 1:24 PM

7.

Collaborating to Develop New Practice Randomization Trials for NCORP CCDR Webinar Series

Please select the session date(s) that you plan to attend. You can locate the agendas
for each day on the registration page.
Check all that apply.
Demystifying the Practice Randomized Trials & Their Use in NCORP CCDR – October 24,
2021 | 4:00 - 5:30 p.m.
Realities of Practice Randomized Trials in NCORP CCDR – November 18, 2021 | 4:00 - 5:30
p.m.
Making the Numbers Work: Statistical Considerations – December 7, 2021 | 4:00 - 5:30 p.m.

https://docs.google.com/forms/d/1qbQkQYh6PDmW7Ydi5CGJ5V1vIQzNYUGma9uMWmEobck/edit

3/5

9/16/21, 1:24 PM

NCORP
List

Collaborating to Develop New Practice Randomization Trials for NCORP CCDR Webinar Series

1.	 Alliance NCORP Research Base

2.	 Atlantic Health NCORP

3.	 Aurora NCORP 

4.	 Baptist Memorial Health Care/Mid-South MU NCORP

5.	 Bay Area Tumor Institute NCORP 

6.	 Cancer Research Consortium of West Michigan (CRCWM) NCORP

7.	 Cancer Research of the Ozarks NCORP 

8.	 Cancer Research of Wisconsin and Northern Michigan (CROWN) Consortium
NCORP

9.	 Carle Cancer Center NCORP

10.	 Childrens Oncology Group NCORP Research Base

11.	 Catholic Health Initiative NCORP

12.	 Columbia University MU NCORP

13.	 Columbus NCORP

14.	 Dayton Clinical Oncology Program NCORP

15.	 Delaware Christiana Care NCORP

16.	 ECOG-ACRIN NCORP Research Base

17.	 Essentia Health Community Cancer Research Program NCORP

18.	 Florida Pediatric NCORP

19.	 GA CaRes MU NCORP

20.	 Geisinger Cancer Institute NCORP

21.	 Georgia NCORP

22.	 NCORP of the Carolinas NCORP 

23.	 Gulf South MU NCORP

24.	 Hawaii MU NCORP

25.	 Heartland Cancer Research NCORP

26.	 Iowa-Wide Oncology Research Coalition (I-WORC) NCORP

27.	 Kaiser Permanente NCORP

28.	 University of Kansas MU NCORP

29.	 MaineHealth NCORP

30.	 Medical University of South Carolina MU NCORP 

31.	 Metro-Minnesota Community Oncology Research Consortium (MMCORC) NCORP

32.	 Michigan Cancer Research Consortium NCORP

33.	 Montana Cancer Consortium NCORP

34.	 Montefiore MU NCORP

35.	 National Capital Area (NCA) MU NCORP

36.	 Nemours NCORP

37.	 Nevada NCORP

38.	 New Mexico MU NCORP

39.	 Northwell Health NCORP

40.	 NRG Oncology NCORP Research Base

41.	 Pacific Cancer Research Consortium NCORP
42.	 Puerto Rico MU NCORP

43.	 Sanford Community Cancer Program of the North Central Plains NCORP

44.	 Southeast Clinical Oncology Research Consortium (SCOR) NCORP 

45.	 Stroger Hospital of Cook County (SHCC) MU NCORP 

46.	 SWOG NCORP Research Base

47.	 Texas Pediatric MU NCORP

48.	 Upstate Carolina Consortium - Community Oncology Research Program NCORP

49.	 URCC NCORP Research Base

50.	 VCU Massey Cancer Center MU NCORP 

51.	 Wake Forest NCORP Research Base

52.	 Western States Cancer Research NCORP

53.	 Wisconsin NCI Community Oncology Research Program (WiNCORP)


https://docs.google.com/forms/d/1qbQkQYh6PDmW7Ydi5CGJ5V1vIQzNYUGma9uMWmEobck/edit

4/5

9/16/21, 1:24 PM

Collaborating to Develop New Practice Randomization Trials for NCORP CCDR Webinar Series

This content is neither created nor endorsed by Google.

 Forms

https://docs.google.com/forms/d/1qbQkQYh6PDmW7Ydi5CGJ5V1vIQzNYUGma9uMWmEobck/edit

5/5


File Typeapplication/pdf
File Modified2021-09-16
File Created2021-09-16

© 2024 OMB.report | Privacy Policy