Neuroscience fMRI Study Proposal Submission Form

Study Title Principal Investigator Name Principal Investigator Email Institution / Department

Team Members

Study Description

Aims & Objectives Methods & Experimental Design Participant Information Inclusion/Exclusion Criteria

fMRI Information

Scan Type(s) Required Estimated Scan Duration (per participant) Number of fMRI Sessions Brief Analysis Plan

Timeline and Funding

Proposed Start Date Funding Source/Status Ethics Approval Status

Additional Information