CACTIS is now only accepting electronic submissions.
All CACTIS applications (new, renewals or modifications) should be submitted electronically to the CACTIS Coordinator, Deborah Arnold at deborah.arnold@uphs.upenn.edu. Please submit your application documents at least six weeks prior to the next CACTIS review meeting, this allows for the proper processing and review of your submission.
For the applications that are Word files, please click on the appropriate link, fill in the form, save the file with your name and date (i.e., "Jones_08_15_2005.doc"), and then send as an attachment to the CACTIS Coordinator.
Animal CT Research (99 KB)
Research Application Form: Image Anonymization Account Request (68 KB)
Request for Image De-identification (68 KB)
Human CT Research (169 KB)
Specimen/Phantom CT Research (43 KB)
IV Contrast and Pregnancy Test Documentation Form (34 KB)
CT-only Non-pregnancy Test Documentation Form (16 KB)
CT Patient Screening Questionnaire (121 KB)
Radiology Outpatient Order (sample included)(104 KB)If there are any questions regarding the application, please contact:
Deb Arnold
CACTIS Coordinator
Tel: 215-662-4595
CACTIS meetings are held the third Thursday of the month at 12 pm. All submissions must be received no later than 12 pm the Friday before.