IDR Request Form » Integrated Data Repository Research Services » Clinical and Translational Science Institute

Request Type*
The initial consultation up to 2 hours is provided at no charge, following that, the hourly rate of $90/hr for analyst time applies. A typical "IRB-Approved MRN ONLY" request can be serviced in those first 2 hours. For more information regarding Consent2Share visit: https://www.ctsi.ufl.edu/about/research-initiatives/uf-consent2share/
- COVID19 Dataset (DeIdentified)
- Consultation
- i2b2 Registration
- Preparatory Research/Cohort Discovery
- IRB-Approved Consent2Share
- IRB-Approved MRN ONLY
- IRB-Approved Line-level Data Elements
- IRB-Approved IT Built
- Quality Study
i2b2 Instances*
Please select one or all of the following options to initiate your i2b2 Account. You will be contacted via email once your provisioning has been completed.
- UFHealth Gainesville
- UFHealth Jacksonville
- OneFlorida
- NCATS ACT
UserName (UF GatorLink, Shands or UMC JAX Username)*
Please use your UF GatorLink, Shands or UMC JAX Username. This is the ID you most commonly use to Sign On to your network. DO NOT make up a username. We ONLY use domain authentication.
Username domain*
Select the domain of your username.
Role*
Name*
First Last
Email*
This is an internally restricted service, please use username@ufl.edu (GatorLink) or username@shands.ufl.edu (Shands) email addresses only.
Enter Email Confirm Email
PI Full Name*
Name as reflected on Project, IRB or Protocol
First Last
PI Email Address*
PI Email Address as listed on IRB
Enter Email Confirm Email
PI College/Department*
Please list your College and Department
Point of Contact Full Name
Point of Contact for additional information
First Last
Point of Contact Phone Number
Point of Contact for additional information
Point of Contact Email Address
Must be ufl.edu, jax.ufl.edu or shands.ufl.edu email address for secure transfer
Enter Email Confirm Email
Data Use Agreement*
UF Health COVID-19 De-identified Dataset for Research These data are approved for use by the UF and UF Health community only, and approved only for research purposes. These data should not be shared outside of the UF/UF Health organization. These data should not be used for non-research purposes. Research publications based on these data should publish only aggregate analyses. Users of these data agree not to attempt to re-identify any patients whose data are included in the data. Research publications using these data should acknowledge the UF Clinical and Translational Science Award and the UF Health Integrated Data Repository team. UF Health care teams interested in these data for operational or clinical purposes should contact the IDR team IRBDataRequest@ahc.ufl.edu for additional guidance.
- Read and understand Data Use Agreement
IRB Number*
IRB Number*
We ONLY provide MRNs and no other data elements for this type of data request
IRB Expiration Date
QIPR number*
QIPR Title*
Please write the full title of your project
Project Description*
Describe the intent of the project. Use IRB Title/Description when pertinent. **PLEASE DO NOT INCLUDE ANY PHI**
Inclusion Criterion*
List all your inclusion criterion. Please include ICD and/or CPT codes. **PLEASE DO NOT INCLUDE ANY PHI**
Data Elements*
List all data elements you are requesting from the IDR for your study or protocol. Do NOT include data elements that you will collect yourself by doing chart review or from other sources. Ensure the requested data elements are listed in your approved IRB. **PLEASE DO NOT INCLUDE ANY PHI**
For Jacksonville investigators, are you working with the Center for Data Solutions (CDS) on this project?*
Name
This field is for validation purposes and should be left unchanged.