REDCap External User Access Request

To begin your account creation process, please follow the instructions and accurately complete the form below.

* Important Notes *

This form is for users attempting to access a REDCap instance for which they are unable to log into directly using their network credentials. If network credentials are available, they should be used to create an internal user account and this form should NOT be used.

After completing this form, you will be sent a confirmation email containing final instructions. You MUST follow the instructions in that email, or your account will not be created. For project access, please remind the PROJECT OWNER to add you as a user.

This form is used to facilitate new REDCap accounts with Wake Forest Baptist Health. Anyone ultimately being granted a REDCap user account, must comply with the Wake Forest Baptist Health REDCap policy and Standard Operating Procedures (REDCap Usage Agreement).

Before completing this request, please be sure to have the Wake Forest Baptist Health collaborator's information who will be sponsoring the new REDCap account; they must be a REDCap user themselves. This is required information for all external users, and we will not complete your request without this information.

Please be sure to complete all required fields. Thank you.

Note: Admin will create your account, but the project team will add you to the project.

Which REDCap instance needs to be accessed?

* must provide value

Atrium Health (rces.atriumhealth.org/redcap)

Wake forest External (https://redcap.wakehealth.edu/redcap)

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Please speak with your project collaborator to confirm the appropriate REDCap instance before continuing. We will be unable to move forward without this information.

Are you a Wake Forest Baptist Health Employee or External User?

* must provide value

Wake Forest Baptist Health Employee

External User

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If the domain for your email matches the location referenced in the selected URL, you should be able to log in using your network credentials and an account will not be manually created.

Example 1: redcap instance = rces.atriumhealth.org/redcap; email = fname.lname@atriumhealth.og

Example 1: redcap instance = redcap.wakehealth.org/redcap; email = fname.lname@wakehealth.og

Please go to the login screen and input the username and password you use to log into the system/EHR/etc.

If you have an account and are having trouble logging into it, please submit a LiftCap request.

Please provide the following information, as a WFBH teammate submitting this form:

First Name:

* must provide value

Last Name:

* must provide value

Institutional Email address:

* must provide value

Wake Forest Baptist Health Login/User ID:

* must provide value

Department:

* must provide value

Please provide the following information for the internal user sponsoring the account:

First Name:

* must provide value

Last Name:

* must provide value

Institutional Email address:

* must provide value

Wake Forest Baptist Health Login/User ID:

Department:

* must provide value

Please provide the following information for the external user:

First Name:

* must provide value

Last Name:

* must provide value

Email:

* must provide value

External Institution supervisor email:

This SHOULDN'T be your email. Please provide the email of the supervisor at your home institution.

* must provide value

Please review to make sure that you've provided your supervisor's email. If one isn't provided or matches your own email, we'll need to reach out before account creation, which will delay the process.

Thanks!

Reason for Requesting Access:
(Please include REDCap Project Title(s) the new user will be added to)

* must provide value

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