The code block below illustrates how one might use # and // as comments in your logic and calculations.

This value you provided is not a number. Please try again.

This value you provided is not an integer. Please try again.

The value entered is not a valid Vanderbilt Medical Record Number (i.e. 4- to 9-digit number, excluding leading zeros). Please try again.

The value you provided must be within the suggested range

The value you provided is outside the suggested range

This value is admissible, but you may wish to double check it.

The value entered must be a time value in the following format HH:MM within the range 00:00-23:59 (e.g., 04:32 or 23:19).

This field must be a 5 or 9 digit U.S. ZIP Code (like 94043). Please re-enter it now.

This field must be a 10 digit U.S. phone number (like 415 555 1212). Please re-enter it now.

This field must be a valid email address (like joe@user.com). Please re-enter it now.

The value you provided could not be validated because it does not follow the expected format. Please try again.

Required format:

aANjpyDnHTzJbyQfgaKPgWPdWrv3n5hDxExAHstkNq6p

Request Access Authorization to a Research System

Returning?

A A A

Requesting user access to eResearch requires a VALID ACTIVE Southwestern ID, Parkland ID or Children's ID before filling out this form. UT Southwestern, Parkland or Children's employees who already have a valid active User ID at their institution may fill out the form to request eResearch system access.

NOTE: RAS requires a minimum of 3 full business days to process your request.

NOTE: If the information in this from is incorrect or incomplete, the user access will not be granted and the applicant will be advised to submit a new corrected request.

NOTE: Accessing UTSW eResearch systems from outside UT Southwestern will require VPN. Please contact your campus Information Technology support team for assistance with VPN.

STANDARD ACCESS

Standard access will be assigned for the systems based on this eResearch Access Request form. Standard access allows a user to create studies, as well as manage and view only those studies on which the user is listed as a study team member. This access is sufficient for most research staff.

SPECIAL OR EXPANDED ACCESS
Some users will need to view studies with which they are not associated as a study team member; such as, Department Approvers, Performance Site Approvers, etc. Such users will need to request expanded access in order to view the studies with which they are not ordinarily associated.

IF YOU REQUIRE SPECIAL OR EXPANDED ACCESS, first ensure you have standard access to the eResearch systems. Afterward, please submit the Expanded Access Authorization to an eResearch System form through ServiceNow.

Access to the Expanded Access Authorization form will require UTSW assigned network user credentials. If you are not a UTSW employee, or affiliate institution user with UTSW assigned credentials, you must coordinate with administrative staff within your UTSW sponsoring department to have the form submitted in your behalf.

For problems, questions or concerns regarding expanded access please open a ServiceNOW incident with the UTSW IR Service Desk at 214-648-7600 or ServiceDesk@utsouthwestern.edu.

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COI ROLE
For questions regarding COI, please contact the UTSW Conflict of Interest (COI) offices:

Conflict of Interest (COI) Office
conflictofinterest@utsouthwestern.edu
Tel 214-648-5300
www.utsouthwestern.edu/coi

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Please note that if you will be accessing the eResearch systems from outside UT Southwestern you must use VPN.

Additional information can be found on the RAS Website.

If you experience any problems with this request form, or if you have any problems accessing any of the systems after receiving notice of access granted, please contact the UT Southwestern Service Desk at 214.648.7600 or ServiceDesk@utsouthwestern.edu.

System Access Requested

* must provide value

Velos

eIRB

eGrants

Topaz (for Animal Research ONLY)

Velos is a study management tool used to help investigators manage the set up and day-to-day activities of human research studies. At UT Southwestern, all research studies conducted on human subjects must be registered in Velos. Additionally, patients involved in the studies can be registered in Velos and enrolled in their respective studies within the system.

eIRB is the paperless submission and document routing system that is used to submit new studies, continuing reviews, modifications, study closures, adverse events, etc. related to human research studies. (Studies are first registered in Velos, then pushed to the eIRB system where they are submitted to the IRB for review and approval.)

eCOI is the electronic Conflict of Interest system through which the Statement of Financial Interest forms are submitted to the Conflict of Interest Office.

COI ROLE
The eCOI tab will be automatically assigned to anyone placed on research and, normally, the person will have the role the next day. The only exception to this is for the non-PIs on Topaz studies who are dependent upon the PI or designee to select those individuals as being research.

eGrants is an electronic grants submission system that streamlines the development, routing, and submission of all grant applications that are currently being submitted through the Research Grants and Contracts Office.

Do you need to be listed as personnel on an IACUC protocol?

* must provide value

Yes

reset

Are you an ARC, COI, IACUC, SBC, or SPA office staff member?

* must provide value

Yes

reset

Do you need to receive billing information about animal charges (per diem) or complete other financial transactions within TOPAZ?

* must provide value

Yes

reset

System Role

Standard access will be assigned in the systems based on this eResearch Access Request form. Standard access allows users to create studies, as well as manage and view only those studies on which they are listed as a study team member. This access is sufficient for most research staff. If you need permissions beyond Standard, please reference the instructions above.

Last Name

* must provide value

First Name

* must provide value

Official Email Address
(No personal accounts allowed)

* must provide value

UTSW Employee?

* must provide value

Yes

reset

Job Title
Example: Professor
Example: Resident

Phone
(Only work phone numbers allowed)

* must provide value

Department or Center

(Note: Students not associated with a department should provide the department of their mentor or PI.)

* must provide value

In this section, list ALL User IDs you are associated with at UT Southwestern, Children's and Parkland. (For any institutions which you do not have a User ID, enter "NA".)

Note:
* Enter the User IDs exactly as you would enter them to log into the network or email at the institution.

* The User IDs listed here MUST be issued by UT Southwestern, Children's or Parkland.

* Enter "NA" for any institutions for which you do not have a User ID.

* If submitting on behalf of someone else, please enter their User ID information - not your own.

Enter UT Southwestern User ID (NOT Person #)

(If submitting on behalf of someone else, enter their User ID - not your own.)

* must provide value

Enter Children's User ID

(If submitting on behalf of someone else, enter their User ID - not your own.)

* must provide value

Enter Parkland User ID

(If submitting on behalf of someone else, enter their User ID - not your own.)

* must provide value

Comments

Expand

Form Author:
(enter your name and network username)

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