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Investigator Initiated Research (IIR) Expression of Interest

Please complete this form to submit your expression of interest in an Investigator Initiated Research (IIR) study. This form captures high-level details about your proposed study and enables Cochlear and the Sponsor-Investigator to proactively assess key variables. This early review helps determine alignment with IIR program requirements before investing time and resources into a full application.

Investigator's first name

Investigator's last name

Institution

Email

Phone

Country code

?Select

Area code and number

Country

Select

Address

City

State

Post / Zip code

Select a request

Investigator Initiated Research (IIR)

Research Equipment License Agreement (RELA)

Both - IIR with RELA

Is this study:

Prospective

Retrospective

If product is used, will it be studied under its:

Intended use

Off label

Does this study involve:

Animal subjects

Human participants

Not applicable

Expression of Interest: Provide Hypothesis and Objectives

Expected total participants (N) and controls (if applicable)

Area of interest (Project Category)

Therapeutic Access (e.g. awareness, underserved patient population, referral expansion, remote tools)

Therapeutic Lifecycle Benefit (e.g. new product tools, product upgrades, performance metrics/indication, bilateral)

Sustainable Care Delivery (e.g. clinic efficiencies, remote care, services, surgery)

Other

Institutional Indirect Costs (IDC) (%)

Anticipated Study Duration

Anticipated Funding Amount ($)

Prior funding sources (Select all that apply)

Cochlear IIR

Cochlear Research Equipment License

Other

Not applicable

Concomitant Funding to this proposal (Select all that apply)

Institution funding

NIH

Other manufacturer

Not applicable

Prospective Funding Plans (Select all that apply)

NIH

Other

Not applicable

Is it likely that this project will bring forward new IP?

Yes

No

Unknown

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