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 North American 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:

SQRY6b9VXwXHabYtPshuZJtHwydiqrIQ85xAD45ymFiA9iUQzBZ5Prw2iAHsBiQ4CBf6GYNUJh48LNatsSGaNFUiFyWFxrXS8dRNgnkCEAxkzw2SBmLIcRX3Y

Advarra User Access Form

Please complete the survey below.

Thank you!

University of Pittsburgh- User Access Request Form
Project ID:	Authorized Requestor:
Protocol Name/Number:	Authorized Requestor:
Customer Name:	Current Date:

Advarra Suite Product

* must provide value

OnCore- CTMS

Advarra- eReg

Advarra EDC

OnCore-Analytics

Environment

* must provide value

Staging

Production

Request Type

* must provide value

New User to Study

Existing User - Update/Assign Role or Site

Update Existing User Info

Disable User from Specific Study

Disable User - Remove from OnCore

Resend Login/Invitation

Greeting/Academic Title

* must provide value

Mr.

Ms.

Mrs.

Dr.

PhD

Prof.

reset

Last Name

* must provide value

First Name

* must provide value

Department

* must provide value

Department Name

* must provide value

Cost Center ID

* must provide value

eReg User Roles
Please select the Protocol Staff Role that aligns with your study team responsibilities. Based on role, required training will be assigned. After training is complete, an initial set of permissions in eReg will be granted. Additional permissions can be granted upon request and completion of required training.

* must provide value

Principal Investigator

Co-investigators

Regulatory Coordinator (includes a Research Coordinator who is also responsible for regulatory submissions and file maintenance)

Research Coordinator (not responsible for regulatory submissions and file maintenance)

Research Associate/Assistant

Data Manager

Pharmacist

Statistician

Program Manager of Multicenter

External site team member

External Monitor

OnCore Study Team Roles

* must provide value

Clinical Trial Office Personnel

HSIT

Principal Investigator

Sub-Investigator

Treating Physician (Non-Investigator)

Research Manager

Study Coordinator

Research Nurse

Department Financials Team

OSPARS

OSP

PERIS

Regulatory/IRB (BRANY or Pitt)

Administrator

CMU Personnel

Faculty Mentor

Key Personnel / Support Staff

Primary Study Coordinator

Secondary Study Coordinator

Statistician

EDC Study Team Roles

* must provide value

Data Manager

Monitor

Investigator

Study Team - PHI

Study Team - No PHI

Read-Only

Data Import

Data Export

Study Coordinator

Company/Hospital

* must provide value

Street:

City

* must provide value

State

Zip Code

* must provide value

Country

* must provide value

Timezone

* must provide value

Do you have an existing University of Pittsburgh username?

* must provide value

Yes

reset

Pitt username

* must provide value

Phone

* must provide value

Language

* must provide value

For HSIT use only

Study Team Role: 13, Regulatory/IRB (BRANY or Pitt)
Permission roles:
27, Regulatory - Organizational Unit

View equation

Study Team Role: 12, PERIS
Permission roles:
29, PERIS/OSPARS Final Budget Signoff

View equation

Study Team Role: 11, OSP
Permission roles:
28, OSP Budget Signoff

View equation

Study Team Role: 10, OSPARS
Permission roles:
29, PERIS/OSPARS Final Budget Signoff
30, OSPARS Final Coverage Analysis Signoff

View equation

Study Team Role: 9, Department Financials Team
Permission roles:
23, Financials - Department

View equation

Study Team Role: 8, Research Nurse
Permission roles:
22, Financials - Assigned
17, Subject - Assigned
13, Protocol - Department

View equation

Study Team Role: 7, Study Coordinator
Permission roles:
17, Subject - Assigned
13, Protocol - Department

View equation

Study Team Role: 18. Primary Study Coordinator
Permission roles:
17, Subject - Assigned
13, Protocol - Department

View equation

Study Team Role: 19. Secondary Study Coordinator
Permission roles:
17, Subject - Assigned
13, Protocol - Department

View equation

Study Team Role: 6, Research Manager
Permission roles:
13, Protocol - Department
18, Subject - Department
23, Financials - Department
31, Manager Signoff

View equation

Study Team Role: 5, Treating Physician (Non-Investigator)
Permission roles:
12, Protocol - Assigned
17, Subject - Assigned

View equation

Study Team Role: 4, Sub-Investigator
Permission roles:
13, Protocol - Department
18, Subject - Department
23, Financials - Department

View equation

Study Team Role: 3, Principal Investigator
Permission roles:
7, Principal Investigator

View equation

Study Team Role: 2, HSIT
Permission roles:
1, Application Administration
10, Roles Administration

View equation

Study Team Role: 1, Clinical Trial Office Personnel
Permission roles:
33, CTO Staff

View equation

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.