Treatment Trial Application

Fields marked with a * are required.

Primary Investigator


If you have multiple degrees please separate them by commas.

Please Enter Your Co-investigator(s)

Treatment Trial Details

Proposal Summary

Please provide a proposal that includes:

  • a) the scientific rationale for the study, citing the relevant basic research and prior clinical experience with the drug
  • b) a detailed study design including outcome measurements
  • c) a description of how the compounds tested will be obtained.

Blood Brain Barrier


References should be limited to 5 pages.

Trial Budget

  • All figures should be in U.S. dollars.
  • Indirect costs may be included here, up to 15% of total costs.

Add each budget Item line by line, specifying the item's category, item name and item amount. Category may be:

  • Personnel/Salary
  • Patient Costs
  • Supplies
  • Equipment
  • Other

Please Note: If approved, grant funding will occur as follows: 25% of funds will be released in advance; 65% of funds will be paid based on number of patients randomized, paid quarterly; and the remaining 10% of funds will be released when SMRI receives the final report.

Sources of Funding

List all sources of funds, pending and secured, related to the proposed research, other than the proposed SMRI funding. Be sure to note if the funding is pending or secured.

Institutional Review Board (Ethical) Approval Status

Please check the appropriate box below. IRB (ethical) approval of your proposed research grant is not required before you submit a grant application. However, if your application is selected for funding, you must provide SMRI with a copy of the relevant approval letter before funding can be released.