Equipment Loan Agreement Intake Form

If you are receiving loaned equipment, please fill out this form.

* indicates required fields.

CONTACTS








Equipment Information














Research





Will the loan of equipment include software?



FDA Approval


Has the equipment been approved by the FDA? *

Will the equipment be used here as approved by the FDA? *


Select the funding source(s) for the research project (check all that apply) *


Have any of the involved Stanford researchers received gift funds from the Lender?

Do any of the involved Stanford researchers have a financial relationship with the Lender (check all that apply)

Have all participating Stanford researchers who are currently identified, including postdocs, students and visiting scholars, signed Stanford’s Patent and Copyright Agreement form (SU-18 or SU-18A)? *

After you click “Submit Form” below, you will receive an e-mail confirmation. We will contact the Principal Investigator and individual(s) identified as the Lab Contact/Admin about next steps. For questions, please contact: ico@stanford.edu