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Center for AIDS Research Heersink School of Medicine

Clinical Core Services Request Form

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Is the PI the contact person?
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Are you an Early Career Investigator (no R01)?
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Are you a student?
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Are you requesting assistance related to a CFAR Pilot Project?
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Is this a pilot grant application or a pilot project that has already been funded?
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Is there a deadline for the requested service?
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What is the IRB status of this project?
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What is the funding situation for this project?
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Services Requested
Which Clinical Core services are you requesting? (Check all that apply)
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Biostatistical Support Questions
Services Requested (Check All That Apply)
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Specimen Request Questions
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Specimens Sent to:
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Lab Data Phenotype 1
Type of Sample
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Viral Load
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Nadir CD4+
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CD4+ T Cell Count
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Current Antiretroviral Therapy
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Lab Data Phenotype 2
Type of Sample
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Viral Load
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Nadir CD4+
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CD4+ T Cell Count
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Current Antiretroviral Therapy
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Please Complete the Database Request Form 
Data Request Form
Example of Completed Data Form #1
Example of Completed Data Form #2
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Are you...
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What is your (PI) title?
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Please note the CFAR Citation Policy for publications that utilized CFAR support. Please remember to cite the NIH award that supports the CFAR (P30 AI027767) and follow the NIH Public Access Policy.
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Acknowledge the Center

Support the UAB Center for AIDS Research by acknowledging services in publications, abstracts, and grants. Cite us: This research was supported by the University of Alabama at Birmingham (UAB) Center For AIDS Research CFAR, an NIH funded program (P30 AI027767) that was made possible by the following institutes: NIAID, NCI, NICHD, NHLBI, NIDA, NIMH, NIA, NIDDK, NIGMS, NIMHD, FIC, NIDCR, and OAR.