CSTR REDCap New Project Request

Please complete the REDCap project request form below.

Project Title
PI or Project Lead
PI Affiliation
Project Contact if different from PI/Project Lead
Email of Project Contact
Purpose of Project
If "Other" please specify purpose:
Please give a brief description of the intent of the project.
Type of Project

Type of Project Single Survey Data Entry Forms (traditional database) Single Survey with Data Entry Forms (e.g. survey with follow-up data capture)
Number of Users

Number of Users 1 2 3 4 5

Each new user will require the PI to submit a separate User Request form.
*

I acknowledge that all work done within this REDCap Instance must support the goals of CSTR.
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I acknowledge that I am compliant with all necessary regulations
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I acknowledge that the users I authorize to assist with this project are compliant with all necessary regulations, have acquired the required IRB approval, and are compliant with HIPAA and Texas Laws relating to the privacy and security of health related data.
Information about required HIPAA training

More information about the training requirements for HIPAA compliance are available at the School of Public Health website.