Request for Statistical Consulting

1.  Name    2.  Date     

3.  Campus Address/or other contact address:

4.  Department      

5.  College             

6.  Phone    7.  Fax 

8.  Email  

9.  Status  Faculty Staff Ph.D. Student MS Student Other Please, Select One  

     If you are a member of PRI or GCRC, please check appropriate box below:

     Member of PRI    Member of GCRC

10. Advisor or Project Supervisor

11.  Time available to meet with consultant 

12.  Project Title:   

13.  What would you like from the Statistical Consulting Center?  Please note: The SCC does not provide tutoring or assistance for class assignments.

Short-Term Statistical Advice.  See Short Term for assistance available. 

Long-Term Funded Statistical Advice and/or SERVICES.  See Long Term for assistance available.

Other:  

14.  Have you visited the Statistical Consulting Center before? No    Yes  If Yes, semester Fall Spring; year ; Consultant

15.  What questions do you have?  Use this space for any additional information that will help the consultant understand what you want from the SCC.  This should include:

     1-What are your research questions/hypotheses? (This could include a description of your project, a list of variables, diagrams, plots and summary tables)

    2-What are your statistical questions?

16.  Type of consulting problem.  Please indicate the current stage of your project: Planning Stage; Analysis Stage; or Other.  After indicating which stage your project is in, checkmark the boxes found beneath your current stage to indicate the topic(s) we can assist you with.  This information is used to find the best match between consultant and client.  Your consultant will also go over this form with you to help clarify the consulting problem.

Study Design:

Analysis and Interpretation of Data:

Other Types of Assistance

17.  Your statistical background (Please check areas you are familiar with)

18.  Computer packages you plan to use:

SAS  Minitab  SPSS  Excel 

Other:

19.  How did you find out about the Center?

Advisor    Web Page    Faculty Member    Friend

20.  I have received approval from the Office for Research Protections (ORP) for the research project referenced above.  (Please note that if your study involves people or animals, you may need approval from the ORP.  For more information,  please see web page http://www.research.psu.edu/orp/index.html .)

YES   NOT NEEDED

Please scroll to below the 'For Office Use Only' portion, and click on the submit button.  Thank you.

(For office use only) ID#: ____________________ Assigned by:______________________ Appointment information: DATE: __-__-__ TIME: _______ ROOM: __________ CONSULTANT: _________________ Five Key Words: 1. ____________________ 2. ____________________ 3. ____________________ 4. ____________________ 5. ____________________ Study Type: Designed Experiment; Survey; Observational Software: Minitab; SAS; SPSS Stage: Planning; Analysis