CHOP Research Institute Faculty Onboarding Questionnaire

General Information

Date:
Name:*
Current Institution:*
Address:*
City:*
State:*
ZIP code:*
Country:*
E-mail:*
Phone:*
Best time to contact you:* (e.g. 9 a.m., 1 p.m.)

The Children's Hospital of Philadelphia Employment Information

Please refer to your offer letter for details.

Start date:

Department/division:*

Job title:

Area of research (please select all that apply):

Research Human Resources

For additional detailed information regarding any of the administrative groups below, please visit the CHOP Research Institute Web site at www.research.chop.edu.
1. Will you be a CHOP-based Penn faculty member?	Yes No
2. Are you currently a CHOP employee?	Yes No
If yes, are you currently at the instructor level?	Yes No
3. Are any of your current staff members moving with you to CHOP?	Yes No
If yes, please list how many staff members are moving with you to CHOP and what position(s) they hold (i.e., postdoc, lab technician, lab manager, MD fellow, etc.):
For questions, please contact: Leon Jones Senior Human Resources Business Partner 267-426-6637 jonesleo@email.chop.edu Please feel free to contact Leon Jones for more information regarding the following topics: New hire packet Pre-employment drug screen and health assessment FBI fingerprinting and child abuse clearances Mandatory CHOP orientation SCOUT hiring manager Supervisory code set up in Lawson VISA issues Information on relocating to Philadelphia

Department of Research Resources

1. Are you relocating to the Philadelphia area?

Yes No

2. Do you require a moving company to relocate your home and/or your research program?

Yes No

3. Do you have capital equipment purchases (purchases of more than $5,000) that you plan to make before or immediately upon your arrival at CHOP?

Yes No

4. Please indicate which of the following types of materials you need to move from your current institution to CHOP. Select all that apply.

*Specialized equipment (e.g., freezers, CO₂ incubators, tissue culture hoods, mass spectrometers, etc.)

5. Please list all specialized equipment (e.g., freezers, CO₂ incubators, tissue culture hoods, mass spectrometers, etc.) that you plan to bring to CHOP. Please indicate model numbers and serial numbers, if available.

6. Please list specialized equipment that will require an emergency power source (i.e., -80°C and -20°C freezers, CO₂ incubators).

Prior to your arrival, the Department of Research Resources will contact you. For questions, or if you do not hear from them within one to two weeks of submitting this form, please contact:

Howard Eck
Director, Department of Research Resources
215-590-4662
eck@email.chop.edu

Department of Research Information Systems

Research Compliance and Regulatory AffairsCONTACT

1. Do you have any IACUC protocols to transfer or submit upon your arrival?	Yes No
2. Do you have current Institutional Review Board (IRB) protocols to transfer?	Yes No
3. Upon transferring your IRB protocol(s) will your current institution remain the institute of record?	Yes No
If you answered yes to question one, the Institutional Animal Care and Use Committee will contact you. If you do not hear from them within one to two weeks of submitting this form, please feel free to contact: Deborah Barnard Director, Research Compliance and Regulatory Affairs (267) 426-9367 barndardd@email.chop.edu If you answered yes to question two or three, the Institutional Review Board will contact you. If you do not hear from them within one to two weeks of submitting this form, please feel free to contact: Amy Schwarzhoff Director, Human Subjects Research (267) 426-2346 schwarzhoffa@email.chop.edu

Clinical Trials Office (CTO)CONTACT

1. Will you need to hire clinical study personnel to assist with your clinical research?	Yes No
2. Will your research involve an Investigational New Drug application?	Yes No
If you answered yes to either question, the CTO will contact you. If you do not hear from them within one to two weeks of submitting this form, please feel free to contact: Lisa Speicher, PhD Director, CTO 267-426-0679 speicher@email.chop.edu

Clinical and Translational Research Center (CTRC)CONTACT

Please visit CTRC external website to learn more about the CTRC and the resources available to CHOP investigators.
Do you plan to use the resources provided by the CTRC at CHOP?	Yes No
If you answered yes, the CTRC will contact you. If you do not hear from them within one to two weeks of submitting this form, please feel free to contact: Ronnie Mazzaccaro Administrative Director, CTRC 215-590-2215 mazzaccaro@email.chop.edu

Core Facilities AdministrationCONTACT

Please visit Core Facilities external website to learn more about the Core Facilities services available to CHOP investigators.
Do you plan to use any of the interdepartmental, clinical, or laboratory core facilities at CHOP?	Yes No
If you answered yes, Core Facilities Administration will contact you. If you do not hear from them within one to two weeks of submitting this form, please feel free to contact: Lisa MacDowell Administrative Director, Core Facilities Administration 267-426-7896 macdowell@email.chop.edu

Office of Postdoctoral AffairsCONTACT

Are you bringing postdocs or other trainees (e.g., MD fellows, training grant fellows, etc.) from your current institution to CHOP?	Yes No
If you answered yes, the Office of Postdoctoral Affairs will contact you. If you do not hear from them within one to two weeks of submitting this form, please feel free to contact: David Taylor, PhD Academic Programs Officer, Office of Postdoctoral Affairs 267-426-0220 taylord@email.chop.edu

Office of Responsible Research Training

The Office of Responsible Research Training will contact you to discuss the training requirements that apply to you and your staff. If you do not hear from them within one to two weeks of submitting this form, please feel free to contact:

Milara Joseph
Training Coordinator, Office of Responsible Research Training
267-426-2835
josephm@email.chop.edu

1. Do you have any grants and/or awards that must be transferred to CHOP from your current institution?	Yes No
If yes, please list the type of grant(s) and/or award(s).
2. Are you submitting any future award applications immediately before or upon your arrival?	Yes No
If yes, please list the type of application(s).
3. Do you have other miscellaneous agreements (i.e., consulting, storage, etc.)?	Yes No
If yes, please list the type of agreement(s).
Prior to your arrival, the Department of Sponsored Projects and Research Business Management will contact you. For questions, or if you do not hear from them within one to two weeks of submitting this form, please contact: Sara Dubberly Director, Sponsored Projects and Research Business Management 215-590-6162 dubberly@email.chop.edu

1. Will you be purchasing new computers upon your arrival at CHOP?	Yes No
2. Are you bringing computers with you to CHOP?	Yes No
3. Does your research result in heavy data use?	Yes No
If yes, what are your anticipated storage requirements?
4. Do you plan to run your own file servers at CHOP?	Yes No
5. Do you have a Web site or Web-based program that you would like to discuss transitioning to CHOP?	Yes No
6. Does your research require secure file transport?	Yes No
7. Does your research involve imaging?	Yes No
Prior to your arrival, the Department of Research Information Systems will contact you. If you do not hear from them within one to two weeks of submitting this form, please feel free to contact: Robert Del Campo Assistant Director, Department of Research Information Systems 267-426-1999 delcampo@email.chop.edu

1. Will your research require special containment (i.e., Biosafety Level 3)?	Yes No
2. Will your research require the use of an irradiator?	Yes No
3. Will you be using select agents (i.e., agents regulated by the Department of Homeland Security)?	Yes No
4. Will your research involve radioactive materials?	Yes No
5. Do you currently have Institutional Biological Safety Committee-approved protocols for work that will be transferred to CHOP?	Yes No
The Office of Research Safety will contact you to discuss your research program. If you do not hear from them within one to two weeks of submitting this form, please feel free to contact: Ray Colliton Research Safety Program Officer, Office of Research Safety 267-426-2272 colliton@email.chop.edu

1. Are you bring research materials such as cell lines, antibodies, etc., to CHOP?	Yes No
2. Will you be transferring a corporate sponsored research program(s)?	Yes No
3. Do you have research that may lead to patents or licensing?	Yes No
4. Do you have any current patents or patent applications?	Yes No
5. Are you participating in a start-up company based on your research?	Yes No
6. Do you currently, or are you planning to have, Clinical Trial Agreements?	Yes No
If you answered yes to any of the above questions, the Office of Technology Transfer will contact you. If you do not hear from them within one to two weeks of submitting this form, please feel free to contact: Ellen Purpus, PhD Director, Office of Technology Transfer 215-590-4660 purpus@email.chop.edu Debbie Schmidt Associate Director, Corporate Sponsored Research 215-590-0174 schmidt@email.chop.edu

Faculty Onboarding Questionnaire

General Information

The Children's Hospital of Philadelphia Employment Information

Research Human Resources

Department of Research Resources

Sponsored Projects and Research Business Management

Department of Research Information Systems

Research Compliance and Regulatory AffairsCONTACT

Clinical Trials Office (CTO)CONTACT

Clinical and Translational Research Center (CTRC)CONTACT

Core Facilities AdministrationCONTACT

Office of Postdoctoral AffairsCONTACT

Office of Responsible Research Training

Office of Research Safety

Office of Technology TransferCONTACT