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The electronic User Access Request for Clinical Applications form is to be completed if you are seeking rights to access and use clinical applications on the Clinical Oncology Research Entrance (C.O.R.E.), eSubmission or Natural Language Processing Resources. The form can be accessed via RedCap by clicking on the blue button below. You may submit only on request per form.

Questions?  

Review the FAQ and Redcap Images below or contact HDC Support, 206.667.2557 for assistance.


Clinical Application User Request Form FAQ

I understand the form is now an online web form (survey), not a PDF. Has the form content changed?

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Yes, the form has changed (except for Gateway and Lab Vision) as it now asks why you are accessing the data. Under state, legal and contractual requirements, data used for research must be treated differently than data used for operations or for patient care. While these requirements are not new (nor have they changed), the new form more clearly and accurately asks the questions necessary to meet these requirements. Fred Hutch has always met the requirements; this form simply helps us do it more efficiently.

Other general changes:

  • Hard copy no longer needs to be mailed or faxed to HDC Support. 
  • The repository access HDC Confidentiality Pledge is no longer built into the form. Requesters who seek data for research or preparatory to research purposes may need to sign and submit an HDC Confidentiality Pledge.
  • Data training will still need verification for receipt of or access to Identifiable Patient Information.
  • The location of the online requests form can still be found through a link on the C.O.R.E. landing page but it can now also be found on CenterNet and Extranet. 
  • The repository access HDC Confidentiality Pledge, Training and Verification form are also located on CenterNet and Extranet. 

Please note: To request access to Gateway and LabVision, a PDF form still applies; the user will still complete and return the PDF by scanning and emailing to HDC_Support@fredhutch.org, faxing or mailing to Martin Tran at 206.667.7834 / Mailstop J3-400.

Will this new form make me do more work?

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This depends on what you are asking for. If you are asking for access to FYI, Comparative Medicine or another application which does not provide access to Identifiable Patient Information, this form requires less work. Here is a summary:

  • Hard copy no longer need to be mailed or faxed to HDC Support. 
  • A repository access HDC Confidentiality Pledge and training verification are no longer required for applications that do not provide access to Identifiable Patient Information. 
  • When selecting an application that provides access to Identifiable Patient Information, you will be asked for the intended use of the data. 
  • For the purpose of research (or preparatory to research), you will continue to be asked for: 
        1) the name and number of the approved protocol
        2) a signed repository access HDC Confidentiality Pledge and
        3) proof of training
  • For purposes other than research (or preparatory to research), you will not be required to provide the name of the approved protocol nor a signed HDC Confidentiality Pledge. Data Access Training verification will still be requested.
  • This form will ask you to verify Data Access Training (data privacy) within the last year. If your last training is over a year old, we are asking you to take the short training again. The training is also accessible through a link in the form.  

Can I leave and save the form mid-way and come back?

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Yes. You will be able to save and exit the electronic request before you submit. This will enable you to leave the form to complete an HDC Confidentiality Pledge or Training Verification and then return where you left off.

The image below shows the first page of the electronic request and the cues for saving and returning (red box). At the bottom of each page, you can select “Save and Return Later”. This will give you a code, which you will need to save. When you are ready to re-start the electronic request, open the survey and select “Returning” in the upper right hand corner. The form will provide you a place to enter the code and start again.

If you lose your return code, contact Martin Tran at HDC_Support@fredhuch.org and he can provide you the return code.
NOTE: this return code will allow anyone to enter and edit your electronic request.

I need to have someone else sign the form before I submit. How do I have my supervisor sign this form? Can I forward the incomplete survey?

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Electronically forward (via email, etc.) the return CODE and URL link to the survey to your supervisor, along with any other documents s/he needs to sign and upload. Your supervisor can then open the link, enter the return code, upload any documents and complete the survey as required.

How do I deal with this new electronic request form when submitting a repository access Confidentiality Pledge?

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The HDC Confidentiality Pledge will be required of those users seeking access to Identifiable Patient Information for the purposes of research or preparatory for research. The electronic request survey provides a place for you to upload and submit a signed Pledge.

You may upload the repository access HDC Confidentiality Pledge originally approved with the protocol. If you don’t have a copy of that document or for whatever reason need a new Pledge form to sign, the electronic request provides a link for you to download a blank HDC Confidentiality Pledge and upload a signed form. 

The HDC Confidentiality Pledge requires a signature of both the Primary User and the PI/Supervisor (or a single signature if the primary user and the PI/supervisor are the same).

I was deactivated due to “no entry.” How do I get reactivation for the same project?

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If you need reactivation for the same project, contact HDC Support or 206.667.2557. If you need access for a new purpose, please complete the electronic form.

RedCap Form Images

When you need to return to YOUR survey, open a new survey and choose "Returning?" (highlighted with a red box in the image below).

Image of Red Cap User Access Request form to Clinical Applications
Image of Red Cap User Access Request form to Clinical Applications

When you select “Save and Return” you will see the following. Note the Return Code.

Survey Code
Return Code for saving form and completing at a later date
Request User Access to Clinical Applications Return Login image
Request User Access to Clinical Applications Return Login image