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YDR-CTO Image Research Request Form

All research studies utilizing Diagnostic Imaging hospital/affiliated facilities imaging equipment or research studies requesting a Diagnostic Radiology clinical services and clinical research coordinator must be reviewed and approved by the YDR CTO Committee. All investigators must complete this YDRCTO form (there is a single approval process for both YNHH and the university department). Please complete and submit to along with the protocol and imaging reference. Once submitted, it will be sent for review to the appropriate hospital staff. Study staff will receive approval documentation with CPT codes and fees upon approval which may take up to 4 weeks.

Click Here to Access the Request Form!