REQUEST FOR SLOTS ON THE CBU Trio MRI

Name of experiment:  									

Is this a new proposal, or request for more slots for an existing experiment?  			

When did the primary researcher give an IIG feedback for any previous MRI experiment?  	

Researchers involved:   									

Primary contact tel (and email, if not CBU): 						

Funding source (if not CBU), or QQR project code (if CBU): 					

If none of the Researchers is an MRC employee, do you have insurance? 			

When was the project proposed at the IIG (necessary if CBU funded)?  				

What is your Ethics Reference? 							            

How many subjects are you testing?  	    			

How many pilots (additional to above) do you want to run (at least 1 week beforehand)?  	 	

Are the subjects patients? If so, please detail. 			

From where will you draw subjects? 			

How many 15min time units per subject are you requesting?  	    			

What is the total EPI time per subject?  	    			

Preparation time (outside scanner)? 				

Any non-standard setup/equipment/procedures (please detail)? 			

Any non-standard (licensed) MRI sequences (if yes, please attach signed permission)? 		

Which headphones will you be using (if any)?				

When do you propose to run the experiment? 						

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Proposal background & basic procedure

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Scanning protocol (please list from http://imaging.mrc-cbu.cam.ac.uk/mri/ImagingSequences)

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Hypotheses and Predictions

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Suggestions from IIG Meeting

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