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Research at Mile Square Health Center

Research Application Form

Our goal is to ensure that the research conducted at or in collaboration with providers at Mile Square Health Center leads to outcomes that can immediately address our health priorities. These health priorities (cancer screening and treatment, behavioral health, diabetes, and cardiovascular disease) were identified from our 2014 University of Illinois Mile Square Health Needs Assessment and from state and national health priority areas. We have adopted a community engagement research model with an emphasis on community-based participatory research to guide our research agenda. We welcome the opportunity to collaborate with partners who have developed a research idea or protocol that fosters community engagement, supports the training of junior and community investigators, and improves health disparities. 

Please review our research guidelines in the above application form. After review, if you feel your research idea or protocol aligns with the current guidelines and priorities or can be modified to fit within these parameters, please complete the entire application form. Character limits are meant to be a guide but if additional space is needed, please submit any essential additional documents with your application. The Office of Community Engaged Research will review research applications on an ongoing basis. Initial proposals will be reviewed within 14 business days. Those proposals most closely fitting with our research priorities and mission will be forwarded to the research council for a full review and determination of appropriateness. The research council meets the 3rd Tuesday of the month. All research applications and accompanying documents are due one week prior to the meeting. Please contact Please contact Samantha Madrid at

Application Checklist
Please ensure the following items have been completed and are emailed with your request (please note N/A, where items are not applicable):

  • Completed MSHC Application for Research
  • Protocol or Protocol Draft
  • Delegation Log (or a summary of duties of research team members including the roles that will be supported by MSHC staff or providers).
  • Budget or Budget Proposal
  • Project Work Plan (Timeline)
  • IRB Application and Approval Letter

Thank you for your interest in collaborating with Mile Square Health Center.