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Required format:

Visiting Scholar Application

Returning?

A A A

To initiate the process for visiting scholar intake by the Office of Research Administration and Quality, please complete this application. Please direct any questions to raqmail@uthscsa.edu.

Thank you!

Please provide your name

* must provide value

Visiting Scholar Last Name

* must provide value

Visiting Scholar First Name

* must provide value

Will the scholar observe or engage in research at UT Health San Antonio?

* must provide value

Yes

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Will the visiting scholar be paid by UT Health San Antonio?

* must provide value

Yes

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Is the visiting scholar currently enrolled as a student in an academic program?

* must provide value

Yes

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If the visitor is foreign, will the visitor need to coordinate with the Office of International Services?

* must provide value

Yes, please put us in touch

Yes, but we are already working with OIS

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Faculty Sponsor Last Name

* must provide value

Faculty Sponsor First Name

* must provide value

Faculty Sponsor Email

* must provide value

Faculty Sponsor Department/Institute

* must provide value

Point of contact for coordinating visiting scholar

* must provide value

Department Chair Last Name

* must provide value

Department Chair First Name

* must provide value

Last Name Dean

* must provide value

First Name Dean

* must provide value

Visiting Scholar Academic Credentials

BA/BS

MA/MS

PhD or equivalent

MD or equivalent

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Visiting Scholar Gender

Male

Female

An option not listed

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Visiting Scholar Residency Status

* must provide value

US Resident

Foreign National

Refugee

Other

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Please describe

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Visiting Scholar Email

Does the visitor have a current visa?

* must provide value

Yes

reset

Passport

Upload file

Date of Birth

* must provide value

M-D-Y

Resident Country

* must provide value

Does the visiting scholar have an appointment at an external institution?

* must provide value

Yes

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External Institutional Affiliation Name

* must provide value

External Institutional Affiliation Address

* must provide value

External Institutional Appointment

* must provide value

This section of the application will ask about the role, responsibilities, and expected work time of the visiting scholars. To help guide your selection, the following definitions of visiting scholar roles are provided. For more detailed information, please visit HOP 7.10.4.

Observer: Individuals who hold an undergraduate or higher degree with interest in a biomedical or health care related field and seeking to observe (i.e., only to shadow, watch, listen, and learn; no hands-on activities allowed) UT Health San Antonio research faculty, including UT Physicians conducting research. Observers cannot provide clinical care, cannot perform any patient care, and cannot participate in or perform research, data collection, or any other hands-on activities.

Professional Trainee: Individuals who hold an undergraduate or higher degree with an interest in a biomedical or health care related field and are seeking additional non-clinical hands-on training in research, for educational purposes or professional development, for their benefit; may participate in research activities, provided they have the requisite training and approval to do so. They may observe clinical practices but cannot provide clinical care, cannot perform any patient care, and cannot have any type of direct patient contact.

Visiting Scientist: The purpose of the Visiting Scientist Program is to bring established and accomplished scholars who can contribute to and enrich the university's research, and intellectual and academic endeavors. Visiting Scientists should currently hold an appointment comparable to UT Health San Antonio faculty. Most Visiting Scientists are granted sabbatical leave from their home universities or research centers. The main purpose is to participate in collaborative projects, conduct collaborative research, and other non-clinical hands-on activities.

Visiting Scholar Type

* must provide value

Observer

Professional Trainee

Visiting Scientist

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Proposed Appointment Start Date

* must provide value

M-D-Y

Proposed Appointment End Date

* must provide value

M-D-Y

Scheduled Work Days

* must provide value

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Workday start time

* must provide value

H:M

Workday end time

* must provide value

H:M

How many hours per week will the visiting scholar work?

Proposed Work Location/s

* must provide value

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Does the visiting scholar have current health insurance?

* must provide value

Yes

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Summary of Intent

* must provide value

Upload file

Visiting Scientist Curriculum Vitae

* must provide value

Upload file

Please download and complete the background check form. Upload the form to the appropriate field once complete.

Attachment:Criminal-Background-Check (3).pdf

Submit the completed background check here

Upload file

Will the visiting scholar work on any sponsored research projects?

* must provide value

Yes

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Grant/proposal numbers related to the sponsored project

Will the visiting scientist work on any internally funded projects?

* must provide value

Yes

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Please provide the title of the project

* must provide value

Will the visiting scholar work on any fundamental/bench science?

* must provide value

Yes

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Will the visiting scholar work on human subjects research?

Yes

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Please provide the IRB protocol number

Please list any grants related to the human research study/ies you listed

* must provide value

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Will the visiting scholar work on animal research?

* must provide value

Yes

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Please provide the IACUC protocol number

Please list any grants related to the animal study/ies you listed

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Will the visitor have access to any UT-owned intellectual property?

Yes

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Please describe the IP

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