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UCSD COVID-19 Research Biobank (C19RB)

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PI First Name*

PI Last Name*

PI Title*

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Affiliation:

Hypothesis and public health relevance:

Research approach and methods (<1 page):

Statement regarding statistical power of proposed study:

Please include all available details of sample type, processing needed and aliquot size:

Please provide required and lower priority clinical data for proposed study:

Please indicate timeframe of proposed study (Note – We may need to prospectively collect your samples):