PANDA Research Partnership Request Form

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Partnership type:

Contact Details

Organisation name

Organisation state

Contact name

Contact title

Contact email address

About your organisation

Have you partnered with PANDA before?

YesNoUnsure

Partnership request details

Please detail what partnership you are seeking

What do you need from PANDA

How would PANDA benefit from partnership?

Outline the research outcomes (research partnerships only)

Please describe

Outline the necessary ethical approvals the project has already received, or are pending (research partnerships only)

Are you building on or contributing an existing evidence base? (research partnerships only)

Key dates/when would partnership activity occur?

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Contact Information