Final Report

indicates a required answer

1. *

Project Title

2. *

Full Name of Primary Investigator (PI)

3. *

Submission date

4. *

Email Address

5. *

Phone Number

6. *

Mailing Address

 

As stated in the Program Announcement, a final written report is due to the IMDTRF Board of Directors within 2 months of the completion of the project. The completed report should be electronically transmitted via this form.

 

Data collection and results: Report on the following aspects of the project:

7. *

Number of subjects originally proposed for inclusion in the study

8. *

Number of subjects enrolled in the study to date

9. *

Number of subjects that have completed the study

10. *

Statistical analysis performed so far

YES NO
11. *

Results to date

preliminary final

Timeline of study

12. *

Summarize your progress on this study relative to the originally proposed time-line. Include variation from that time as well as reasons for the variation and solutions to any problems.

Publications

13. *

Identify progress on the following items including timelines. Please be as specific as possible. Please send a copy of the letter of acceptance for the poster, platform presentation and the journal article as they become available.

14. 

Any general comments related to difficulties or issues with implementing the proposed study

Financial Accountability
Fill in the boxes below as an accounting of the distributed funds for the proposal. All in USD.

Equipment

15. 

Allocated funds

16. 

Spent funds

17. 

Unspent funds

Consumable supplies

18. 

Allocated funds

19. 

Spent funds

20. 

Unspent funds

Consultants

21. 

Allocated funds

22. 

Spent funds

23. 

Unspent funds

Travel

24. 

Allocated funds

25. 

Spent funds

26. 

Unspent funds

Other expenses

27. 

Allocated funds

28. 

Spent funds

29. 

Unspent funds

30. *

Total - allocated funds

31. *

Total - spent funds

32. *

Total - unspent funds

Failure to return this report in a timely manner will result in the returning of grant funds to the IMDTRF.

The Board of Directors of IMDTRF also reserves the right to request the return of monies based on non-compliance with the original study objectives. The IMDTRF Board of Directors will review the submitted summary.

By April 1st, the Board will notify the PI of continued grant status.