Patient and Public Engagement Request for Researchers

This form is intended for researchers wishing to request support from the SPOR Evidence Alliance in identifying and engaging patient and public partners in research projects. The completed form is to be emailed to the central coordinating office at SPOREA@smh.ca. The central coordinating office will circulate the request and connect interested partners to the research team.

Principal researcher and institution
First and Last Name:
Institution:	Email:
Contact person for patient and public engagement
First and Last Name:
Institution:	Email:
Type of review
Review type:
Is it a living evidence synthesis? If so, how often is it updated?
What is the topic?
What is the timeline? (Start date, end date)
At what step(s) to you foresee engaging with the patient and public partners?
☐ At the start – to review question, approach, outcomes ☐ At the analysis stage – to contribute to interpretation ☐ Towards the end – to review key messages ☐ At the plain language summary stage
What is the anticipated time commitment?
Please be as specific as possible. Number of hours for the entire engagement within a specific timeframe. For example, 2-3 hours per week from July 2nd to July 30th.
What will be your primary form of communication?
☐ Virtual meetings (Zoom, Teams, etc.) ☐ Email ☐ Telephone