BECOMING A PCPLC CLINICAL SITE

BECOME A PCPLC SITE

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BECOME A PCPLC CLINICAL SITE

Institution Name

Responsible PI

Address

State

Number of unique ARM patients seen in your clinic each year for the past 2 years:

Number of unique HD patients seen in your clinic each year for the past 2 years:

How many new/redo cases do you see in a year regarding any aspects of colorectal and pelvic reconstruction (genetic, epidemiology, surgery, radiology, psychology, management, followups, etc.)?

Do you have or refer to a Pediatric Surgery Service?

Are you able to commit to the minimum attendance standards for all consortium meetings? (Attend at least 1 of the 2 in-person Steering Committee meetings and a minimum of 50% of the PI/RC monthly calls each year)

Yes

Do you have a designated research coordinator or data entry person that can dedicate at least 40% FTE (16 hours a week) to the consortium?

Yes

Funding for the PCPLC is provided by the participating sites and includes project management, data management, statistical, and general network support provided by the University of Utah’s Data Coordinating Center. Annual dues are approximately $15,000 USD per center. Is your institution able to commit to these annual dues?

Yes

The mission of the PCPLC is to equitably improve the health and quality of life of individuals affected by congenital colorectal disorders and associated urologic, gynecologic, and other anomalies through quality improvement, research, and education.