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LEARNING LAB

Facilitating education for physicians and staff

Learning Lab

The ORF is the business and education manager for the Learning Lab at OrthoIndy Hospital. The learning lab is to facilitate the education of surgeons and staff for new/updated devices, surgical training, and surgical techniques. Please contact Brenda Gould at 317.802.2881 for more information.

If you are interested in utilizing the learning lab, please complete the following forms and submit to Brenda Gould at bgould@orthoindy.com.

Business Associate Agreement

Lab Participant Form

Please fill out the following form to request a learning lab.

Required fields marked with an asterisk (*).

Date of Submission (required)

(required)

OrthoIndy Physician or Course Director

Principal Investigator

Program Sponsor

Point of Contact (required)

(required)

Point of Contact Mailing Address (required)

(required)

Point of Contact Phone (required)

(required)

Point of Contact Email (required)

(required)

Program Title

Number of Participants

Requested Date (First Choice)

Requested Date (Second Choice)

Anticipated Time Needed in Lab

Do you plan to use a camera/recording device during study? Yes
No

If you answered yes above, please explain in what capacity

Please provide a brief summary of the program

Call the ORF today!

317.802.2880

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