CHIS - Research Clearinghouse

Making California's Voices Heard on Health

CHIS Research Clearinghouse - Submit your project

You'll need approximately 5 minutes to complete this process

Please complete the following few web pages. The information will be posted after review. If any further information is needed, we will contact you.

Note: Bold fields are required

Project Title

About the Principal Investigator

First Name

Last Name

Degrees

MA	MPH
MS	MBA
MD	PhD
DrPH

Title

Organization Name

Organization Type

You must select a single primary organization type. For Health Care and Human Service Providers OR Voluntary Agencies and Associations, you may also select additional definitions.
Government Agency
	Federal
	State
	Local

Legislative Office
	Federal
	State
	Local

Educational or Research Institution
	College or university
	Other research organization
	Primary or secondary school

	Health Insurers / Managed Care Organizations

	Health Care & Human Services Providers (Please select all that apply below)
	Health care (hospitals, clinics, physician practices, etc.)
	Human serivces

	Voluntary agencies and associations (Please select all that apply below)
	Health & health advocacy
	Grantor
	Faith-based
	Other

	News Media

	Other (please specify)

Phone Number

Email Address

Address (line 1)

Address (line 2)

City

State

Zip

Can we display your phone number?

Yes No

Can we display your email address?

Yes No


		CHIS is conducted by the UCLA Center for Health Policy Research in collaboration with the California Department of Public Health, the Department of Health Care Services and the Public Health Institute. It is funded by both public and private organizations.