International Association of Gerontology and Geriatrics    
IAGG Global Aging Research Network
Questionnaire for selection process

*Name of the Centre:
*Key Investigator / Head of Department:
*: Required

Description of the Centre:
  a) Type of investigations:
  b) Themes investigated (please specify):
  c) Number of investigators in ongoing positions: 
  d) Number of investigators funded by specific projects:
  e) Does your Centre have a:
  f) Does your Centre have a basic sciences program? (Please specify topic)
If your Centre is affiliated to a Geriatric Department, please provide the following information:
  a) Types of units:
  - Number of beds:
  - Number of patients/year:
  - Number of visits/year:
  - Number of places/day:
  - Number of beds:
  - Number of beds:
  - Number of beds:
  b) Number of staff in the Department:
  c) Does the Day Hospital have specialist services?
  d) Does your Geriatric Department already cooperate with supervising clinical trials?
Management of the Centre:
  a) Is your Centre an existing national or government recognized medical research Centre?
  b) Does the Centre receive funded grants? (Please specify source)
  c) Does the Centre collaborate with trials funded by pharmaceutical companies?
  d) Will the Centre shortly begin investigation projects?
Indicate the three main publications over the last 2 years:
  1/ Name of Journal:
Title of article:
  2/ Name of Journal:
Title of article:
  3/ Name of Journal:
Title of article:
Please add short biographies (maximum 1 page) of the Key Investigators and Head of Department