CHOIR Request for Appointment Form

Fill out the form to request an appointment, with or without stipend support, in the Loyola University Chicago Health Sciences Division’s Center for Health Outcomes and Informatics Research. Approved appointments are for a term of 24 months from date of approval. Please contact Michelle Pencyla, Director of Faculty Administration and Assistant Provost, for processing if you have any questions or concerns.

To Be Considered

Please submit a letter of support from a current chair person as well as a current curriculum vitae to Michelle Pencyla.


E-mail Address:

Confirm E-mail Address:

Appointment Information

Faculty Name:



Primary school appointment:

Date of Appointment:

Primary departmental appointment:

Primary division appointment:

Proposed appointment start date:

Brief description of rationale for appointment: