Reporting Form for Past Grant Recipients

Overview

This online submission system collects data required to report on the ACG clinical research awards. This form is intended for use by funded investigators who received ACG Clinical Research Awards, ACG Clinical Research Pilot Awards, ACG Medical Resident Clinical Research Awards, and ACG Medical Student Research Awards. Under the terms of these awards, reports are typically due December 31st. Questions about the use of this form, deadlines, and reporting requirements can be addressed to research@gi.org.

Name*
First Last
Grant Type
Select the grant category for your award.
Project Title*
Amount of the Award*
For Trainees list the name of your mentor*
Write N/A if you are not in training
Sponsoring Institution where award was held*
Dates of Award Term*
Dates covered by this report (if different from award term)
Office Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
Do you certify that the information being submitted is correct, and that your research has been conducted according to ACG guidlines*
- Yes
- No
Scientific Programs Report: (1200 Characters)*
In the space provided, summarize the results of your work
Describe how your results have affected patient care: (1200 Characters)*
Describe any specific techniques or skills that you acquired as a result of your ACG Award: (1200 Characters)*
List Publications, abstracts, and presentations that resulted directly from this award: (1200 Characters)*
List any additional funding obtained as a result of this award: (1200 Characters)*
Describe in the space provided how the award has influenced your career: (1200 Characters)*
Do you have a financial report to upload below?*
- Yes
- No
Dates covered by the financial report?*
Enter N/A if financial report was submitted separately.
Name & email of financial contact for any question on the finacial report:*
Financial Report Upload
Accepted file types: pdf, xlsx, xls, Max. file size: 50 MB.
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