REDCap Access Request Form – external

Title
Other
Name Name First Last
Email (this will be used to email you when your UOW account is available)
Phone
Organisational Unit/Department
Account Activation Code (4-8 characters/digits)
Must be between 4 and 8 characters. Currently Entered: 0 characters.
Have you ever held a non-student UOW account with UOW?

Have you ever held a non-student UOW account with UOW? Yes No
Reason for requesting access

Reason for requesting access Data Collection Other (please provide details)
Other
Who is your Account Sponsor? (This could be your project coordinator/supervisor and must be a UOW staff/student)
Comments (Optional)
Data collection statement

The information you provide on this form will be used to create an account in a UOW REDCap system. The data will be retained within the required systems and can only be accessed by system administrators. De-identified, aggregated data may also be used for reporting purposes.

Further information regarding UOW’s commitment to privacy can be found at https://www.uow.edu.au/privacy/ or by calling 1300 367 869 within Australia.