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/^((02([-\/])29\3(\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00)))|((((0[1-9]|1[012])([-\/])(0[1-9]|1\d|2[0-8]))|((0[13-9]|1[012])([-\/])(29|30))|((0[13578]|1[02])([-\/])31))(\11|\15|\19)\d{4}))$/

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/^\d{10}$/

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/^[-+]?[0-9]*\.?[0-9]+([eE][-+]?[0-9]+)?$/

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V3KsLuAp5zprZMjVn4tK9U5TiPLNwJmXwVWgUUTbc7rPpEZbfiYXa

Request External Users for REDCap Project

Returning?

A A A

For personnel external to OHSU, the REDCap Team will first need to create a REDCap account before you can add the external personnel to your REDCap project.

Charges:

Annual charge of $100 per 10 users created and/or renewed.
Billing information is required at the time of request, however OCTRI only bills the annual charge once a year for external users.
There are no charges for accounts for Portland VA collaborators or collaborators from other OCTRI partners listed on the request form below.

Billing Info: Alias and FAID numbers, as well as the FAID owner's name are required for billing purposes.

Account Expirations:

External accounts are valid for a fiscal year, expiring annually every August 31st. Portland VA accounts are the exception and will not be set to expire.
For any external users needing continued access, their accounts will need to be renewed every fiscal year, via the the User Sponsor Dashboard.
Renewal requests will be processed annually between July 1st and August 31st.

Account Sponsors:

The person completing this form, the requestor, is designated as the external user's sponsor, unless another REDCap user is requested to be the sponsor.
OHSU and Portland VA personnel are eligible to be sponsors.
All Sponsor users will have access to the a Sponsor User Dashboard, where they can request the REDCap Team's help to do things, like renew an account.

Request Date

M-D-Y

REDCap Project Title

* must provide value

Personnel Completing this Form

As the person requesting an account for an external user, you will be designated as the user's Sponsor.
As the user's sponsor, you will be responsible for requesting external user account renewals, via the User Sponsor Dashboard, for continued access each year, as needed, for all sponsored external users.
If you are not the appropriate person to be the external user's sponsor, you can request to have another REDCap user designated as the sponsor.

Your First Name

* must provide value

Your Last Name

* must provide value

Your Email

* must provide value

Other Sponsor

Designate another OHSU REDCap User as the Sponsor

Sponsor First Name

* must provide value

Sponsor Last Name

* must provide value

Sponsor Email

* must provide value

Sponsor User Credentials

* must provide value

Sponsor user is assigned to the project, ______

ACCOUNTS FOR PORTLAND VA - v1 artifact

Are you requesting accounts for a Portland VA staff?

Yes

reset

Accounts for OCHIN, OSU, PNNL, PSU, VA, UO

If you are you requesting accounts for personnel who have an affiliation with one of the institutions listed below, select the primary affiliation for each user you are requesting an account

OCHIN

Oregon State University (OSU)

Pacific Northwest National Laboratory (PNNL)

Portland State University (PSU)

Portland VA

University of Oregon (UO)

Billing Info
Annual charge of $100 per 10 users.

Billing information is required at the time of request, however charges are annual and OCTRI only bills once a year for external users.

Confirm Account Duration/Expiration (DEPRECATED)

The expiration date for the accounts requested in this form will be set to June 30, 2021. The billing rates, listed above, for this fiscal year and the next fiscal year will apply.

Alias

* must provide value

FAID

* must provide value

FAID Owner (first and last name)

* must provide value

Number of Accounts: First, select the number of REDCap accounts you are requesting

* must provide value

Label

Requestor submitted the information needed to resolve the issue

Label

Requestor submitted the information needed to resolve the issues with the users they requested

You have selected an option that triggers this survey to end right now.

To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.

Request External Users for REDCap Project

Personnel Completing this Form

Accounts for OCHIN, OSU, PNNL, PSU, VA, UO

Billing InfoAnnual charge of $100 per 10 users.

You have selected an option that triggers this survey to end right now.

Billing Info
Annual charge of $100 per 10 users.