REDCap New Project Request

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CEDEP REDCap New Project Request

Please submit the form below to request a new project. The approval process generally takes 2 business days (in most cases projects will be approved the same day). When your project is approved, you’ll receive an automated email message informing you that the project has been created.

If you have questions while completing the form, please contact CEDEP.REDCap@TN.gov.

Note: After the project is created, you will take on ALL Project Owner responsibilities which includes the design, development and administration of the project and management of its users.

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Survey Date/Time

M-D-Y H:M:S

Survey Notification Email

Super User Auto Create Project ID:

First Name

* must provide value

Last Name

* must provide value

Email Address

* must provide value

Phone

* must provide value

REDCap User Name

* must provide value

Note: CEDEP REDCap Projects will only be created for employees working in communicable diseases/emergency preparedness for Central Office or Regional/Metro Health Departments. If you do not fit that description, your request will be denied.

Tennessee Public Health Region

* must provide value

Which CEDEP program area do you work in?

*Select first option if you are with a region/metro health department.

* must provide value

Specify Other Program

* must provide value

Do you have a RACF ID (DC Number) assigned by the State of Tennessee?

* must provide value

Yes No

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What is your RACF ID/DC Number?

* must provide value

REDCap Project Name

* must provide value

Will the project contain any protected health information?

* must provide value

Yes No

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Is this project for an outbreak or cluster investigation?

* must provide value

Yes No

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Provide a brief description of the project

* must provide value

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Do you anticipate importing any data into REDCap from another source (e.g. spreadsheets, another database or information system, etc.)?

* must provide value

Yes No

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Do you anticipate making changes to the forms in this project after it goes into production that will require users to be involved in testing?

* must provide value

Yes No Unsure

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Date you need the project created in REDCap

* must provide value

M-D-Y

Select all types of staff who will be involved in project setup and design within REDCap.

* must provide value

Central Office Staff

Regional Staff (not including Metros)

Metro Staff

External Partners (non-TDH)

Please describe the external partners who will need access to project setup.

* must provide value

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Select all types of staff who will be entering/editing data within REDCap (does require a user name and password). Do not include those who will be submitting data only via a survey (which does not require a user name and password).

* must provide value

Central Office Staff

Regional Staff (not including Metros)

Metro Staff

External Partners (non-TDH)

N/A-Only Entering Via Survey

Please describe the external partners who will need access to data entry.

* must provide value

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Central Office Staff

Regional Staff (not including Metros)

Metro Staff

External Partners (non-TDH)

Identified Dataset

De-Identified Dataset

Would you like to have a consult with the REDCap team for how to most efficiently set up this project?

Yes No

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We can create a playground of your project which would give you a space to be able to try out different features and test the flow of your project.

If you are creating a new project, a playground will also be a blank project; if it is copied from another, it will be an exact copy without any records, (i.e, the forms, features, surveys, etc. will be copied over).

Would you like us to create a playground for you?

Yes No

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Do you need to use SMS/text (Twilio) for this project?
Note: Twilio is a third-party, extra cost service.

Yes

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Auto Approval Calc

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