BIRC EEG Training Request Form

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This form is for individuals with plans to use EEG equipment at BIRC in the near future. Required BIRC-specific EEG training consists of at least one demonstration/informational session and three fully supervised practice sessions with the saline-based equipment. Please do not use this form if you plan on using a system outside BIRC.

Please complete the information below, and we will contact you shortly to discuss scheduling.

Email *

Name: *

I am a: *

Undergraduate student

Graduate student

UConn Faculty

Non-UConn Affiliated

Primary Investigator *

Please provide a brief (1-2 sentence) description of your EEG study. *

Funding mechanism:

BIRC Seed Grant

External grant

Startup/Internal funding (e.g. IBACS, OVPR)

Unfunded

Other:

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When do you anticipate beginning data collection? *

YYYY

Does your study involve simultaneous MRI-EEG? *

Yes

Training will require several 2-hour sessions. Please list days/times that you would generally NOT be able to attend. *

Send me a copy of my responses.

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