← External Research ProgramInvestigator-initiated studies

External Research Application

Please complete all fields to submit your research proposal for review. Proposals route to the research team.

*Indicates required question

Study Title *

Study Product *

Twilight™ Dark AdaptometerSmartERG®

Principal Investigator *

Contact Details *

Institution *

Target Study Population *

Study Rationale *

Primary Objective *

Secondary Objectives *

Statistical Analysis *

Expected Outcomes *

Number of Patients *

Inclusion Criteria *

Exclusion Criteria *

Enrollment Duration *

Overall Study Duration *

Disclaimer *

Scientific grants shall not be contingent in any way on past, present or potential future purchase, lease, recommendation, prescription, use, supply or procurement of EVOQ Technologies products or services.

I acknowledge and agree to this disclaimer

Compliance Affirmation *

I affirm that the scientific grant will only be used for the purpose described. The research to be conducted will comply with the Helsinki Good Clinical Practice and otherwise stated regulatory requirements.

I affirm

Full Name *

Email *

Date of Submission *

Signature *

We’ll review your proposal and follow up at the email you provide.