Request a new REDCap user account

Use this form to request a REDCap account for an existing REDCap project.

Note that this form should be completed either by the person requiring the REDCap account or the Study Manager. If the form is to be completed by the study manager, please discuss this with the new REDCap user prior to filling in the form.

You only to fill in this form once, if access to multiple projects is required, please select the first project requiring access and name additional projects in the comments box.

Please complete the details below:

Please note that REDCap account creation is a manual process and that accounts requests are processed on a Monday & Friday each week.

Project name:

* must provide value

Name of Study Manager:
This is the person responsible for giving access to the REDCap project

* must provide value

Email address of Study Manager:
This is the person responsible for giving access to the REDCap project

* must provide value

New user's first name:

* must provide value

New user's last name:

* must provide value

New user's email address:
Please use an address from an official organisation such as .nhs or .ac.uk

* must provide value

*@HIDDEN
Tick all that apply:

* must provide value

The account is for myself

The account is for another person (I am the Study Manager)

*@HIDDEN
Your email address:

* must provide value

**HIDDEN**
Project name

*@HIDDEN
Your site/data access group:
Leave blank if not applicable/unknown

please state

Does this project include an eConsent form to which access is required?
This will require two separate REDCap accounts.

Yes No

reset

*@HIDDEN
Project end date:

D-M-Y

Comments:

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