Registration for consultation

Notes on the Form

Fill in all fields carefully and correctly, this will save you from back queries and unnecessary delays.
Please always enter an official e-mail address, usually @charite.de, for privacy reasons. If you are employed by an affiliated organisation (e.g. Herzzentrum Berlin), please use your corresponding address (e.g. @dhzb.de).
Charité Doctoral students can simply go to the Charité matriculation office with their doctoral registration and matriculate as a doctoral student. They will then be provided with a Charité email account.
Be realistic. As we try to consider your wishes, requirements too high may lead to delays, because the perfect consultant might be occupied otherwise

Ethics Application for Animal Experiments (LAGeSo)

Before you come in for an Ethics Application for Animal Experiments (LAGeSo), be sure to read these guidelines:

"Statistical review of animal trials-A guideline" and
the associated "UserGuide for Biometric Planning of Animal Trials".

Data Protection & Privacy

Data Sets brought along

In case you plan to bring data records to a consultation, please delete all patient-identifying information beforehand. We only accept psyeudonomized and anonymized records!

Privacy Notice

Please confirm at the end of the form that you have read our privacy notice

Please note

After submitting the form, you will usually be contacted within 10 working days.
We usually offer consultation appointments within 2-3 weeks.
You might experience longer delays

For consultation appointments very early in the morning or in the evening,
During the September vacation season

Registration Form Statistical Consultation

Last Name *

First Name *

Salutation *

Academic Title

E-Mail-Address (preferably @charite.de) *

Please make sure your address is correct, otherwise we will not be able to contact you.

Phone *

Long name of Clinic/Institution
("Charité" or simple indication of Charité-Campus or Charité Center do not suffice
for theses: where work is carried out)*

Info on your Project

Title of your Project *

The above project has been consulted by you, before *

The Project is a Doctoral Thesis, Hausarbeit, Bachelor Thesis, Master Thesis *

First (Given) Name and Last (Familiy) Name of Project Manager or Dotoral Supervisor *

Third-party Funding *

Current Phase of the Project *

The project to be consulted is already a cooperation with the following institutes:

Please note that we at iBiKE do not arrange cooperation for your projects.

CSC (Charité Clinical Study Center, includes CTO and CTU)

BIH (Berlin Institute of Health)

MDC (Max-Dellbrück-Centrum)

Info on Consultation Request

Brief description of your project or the purpose of the consultation request *

If you mark the following field, please always state the name of the consultant as well

An appointment has already been made

Designated Consultant

Consultation Language

Other remarks (requests for specific times, deadlines, etc.)

I have taken note of the above privacy policy information *

yes

The completed form will be sent to us by e-mail, the content could be read by third parties.
In case you do not receive an automated confirmation email to your request, please check for typing errors in the e-mail address you provided as forms with non-existing e-mail addresses will not be forwarded by the system.

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Statistical Consultation Request Form

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