317.880.0000
Careers
News
Events
Contact Us
Vendors
Patients
Researchers
Doctors
Doctor Search
txtDoctorname
ddlSpeciality
Specialty
Addiction Medicine
Adolescent Medicine
Anesthesiology
Audiology
Breast Surgery
Burn Care
Cardiac Electrophysiology
Cardiology
Clinical Neuropsychology
Colon & Rectal Surgery
Dentistry
Dermatology
Diagnostic Radiology
Emergency Medicine
Endocrine Surgery
Endocrinology
Family Medicine
Gastroenterology
General Surgery
Geriatrics
Gynecologic Oncology
Gynecology
Hematology/Oncology
Hospitalist
Infectious Diseases
Internal Medicine
Interventional Radiology
Medical Genetics
Neonatology/Neonatal/Perinatal Medicine
Nephrology
Neurointerventional Radiology
Neurology
Neuro-Ophthalmology
Neuropsychology
Neurosurgery
OB/GYN
Oncology
Ophthalmology
Optometry
Orthopaedics
Otolaryngology
Palliative Care
Pathology
Pediatric Dermatology
Pediatric Otolaryngology
Pediatric Urology
Pediatrics
Physical Medicine & Rehabilitation
Plastic Surgery
Podiatry
Preoperative Medicine
Psychiatry
Pulmonary and Critical Care
Radiation Oncology
Radiology
Rheumatology
Sleep Medicine
Sports Medicine
Surgery
Thoracic Surgery
Toxicology
Trauma
Urology
Vascular Surgery
ddlLocation
Location
3419 English Ave.
5610 Crawfordsville Rd.
Eskenazi Health Center Barton Annex
Eskenazi Health Center Blackburn
Eskenazi Health Center College Avenue
Eskenazi Health Center Grande
Eskenazi Health Center Grassy Creek
Eskenazi Health Center Herron-Riverside High School
Eskenazi Health Center North Illinois Street
Eskenazi Health Center Northwest Middle School
Eskenazi Health Center Pecar
Eskenazi Health Center Pedigo
Eskenazi Health Center Primary Care
Eskenazi Health Center West 38th Street
Eskenazi Health Center Westside
Eskenazi Health Family Planning Glendale
Eskenazi Health Family Planning West
Eskenazi Health Thomas & Arlene Grande Campus
Sandra Eskenazi Mental Health Center - Dr. James J. Wright Building
Sandra Eskenazi Mental Health Center – Thomas P. Stitt Building
Sandra Eskenazi Outpatient Care Center
Sidney & Lois Eskenazi Hospital
ddlGender
Select a Gender
Female
Male
Other
Request an appointment
317.880.0000
Online Request Form
Refer Your Patient
Locations
Eskenazi Health Main Campus
Eskenazi Health Main Campus Map
Eskenazi Health Sites
Eskenazi Health Family Planning Glendale
Eskenazi Health Family Planning West
Eskenazi Health Thomas & Arlene Grande Campus
Eskenazi Health Main Campus Map
Primary Care Sites
Sandra Eskenazi Mental Health Center
Health Services
Addiction Services
Brain Center
Burn Services
Family Beginnings
Mental Health
Orthopaedics
Pharmacy
Primary Care
Senior Care
Spine Care
Surgery
Trauma
Programs
Burn Prevention Program
Community Engagement
DAISY Award
EMBRACE
Financial Counseling
Food as Medicine
Healthy Me
Medical-Legal Partnership
Music Program
Post-Acute Care Collaborative
Public Art Collection
Social Determinants of Health
About
Sidney & Lois Eskenazi
History
Eskenazi Health Foundation
FAQs
Insurance and Pricing Information
St. Margaret’s Hospital Guild
Research Participation
Board of Trustees
Eskenazi Health Center Board
EpicCare Link Request Form
Eskenazi Medical Group
Donate
Sidney & Lois Eskenazi
History
Eskenazi Health Foundation
FAQs
Insurance and Pricing Information
St. Margaret’s Hospital Guild
Research Participation
Board of Trustees
Eskenazi Health Center Board
EpicCare Link Request Form
Eskenazi Medical Group
txtSiteSearch
Researchers
Research Department
Research Approval
Clinical Trial Billing
Grants and Funding
Research Stations
Contact Us
Researchers - Contact Us
First Name
Click to add
(?)
Email
Click to add
(?)
Last Name
Click to add
(?)
Phone
Click to add
(?)
Study Related Information (if applicable)
Project Title
Click to add
(?)
Principal Investigator Name
Click to add
(?)
IU IRB Number
Click to add
(?)
Institution Affiliation
Eskenazi Health
Indiana University
Indiana University Health
Other
Click to add
(?)
What Information or services are you seeking with this request (select all appropriate options)?
Eskenazi Health Research Approval Process
Research Stations - General Information
Research Stations - Scheduling
Research Credentialing - Epic Access
Epic Research Training
Clinical Trial Billing - Procedure Cost (labs, radiology, etc.)
Clinical Trial Billing - Coverage Analysis, Billing Grid
Clinical Trial Billing - Contract and Agreement Management
Agreements - Confidentiality Disclosure Agreement (CDA)
Agreements - Non-disclosure agreement (NDA)
Agreements - Clinical Trial Agreement (CTA)
Agreements - Clinical Trial Budget
Agreements - Data Use Agreement (DUA)
Agreements - Business Associate Agreement (BAA)
Grants and Funding - Grant Agreement
Grants and Funding - Grant Sub-Agreement
Grants and Funding - Requesting Use of Eskenazi Health Clinical or Non-clinical Staff to Be Used When Conducting Research
Research Development Team Assistance (clarify project goals, proposal development support, protocol development assistance, project implementation plans, research informatics, analytics and information technology support)
Other - Please Explain Below
Additional Comments
Click to add
(?)