Formulare – Service Portal

German Centre for Cardiovascular Research: Application for Registration, Re-registration or Deregistration of a User Access for the DZHK-IT infrastructure

Please fill out this form to apply for a new access or a change to an existing access or to deregister.

Fill it out diligently. We will notify you by email after your access has been set up.

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Genehmiger:
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Client-Zertifikat Dauer
- 5 Jahre
- 41 Monate
Deutsch

English

Select your study site

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Projekt*
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Studien*
Please select a study site (page will reload after selection)*
Please select the study site you want to document data for. The page will reload once you have selected a site.
Please select study*
Please select a study you would like to document.
Hold down the control key (“CTRL”) on your keyboard and click with the left mouse button on the desired studies of the list. Please make sure to solely select the studies you are delegated.

Personal data

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salutation
title
first name*
last name*
phone number*
Please leave your phone number for any queries. Please enter your phone number with area code.
email-address*

Your e-mail address is required to send you the access details. The use of a business/official e-mail address is mandatory. Do not use a private e-mail address.

Select your required user access

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- Clinical Data Management System (CDMS or DH, secuTrial®)
- Laboratory Information Management System(LIMS, CentraXX)
- Image Data Management System (IDMS aka. BDMS, TrialComplete)
- I require a client certificate (TTP)
- Deregistration of a User Access (applies to the complete DZHK infrastructure DH, LIMS, BDMS and TTP)
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- Clinical Data Management System (CDMS or DH, secuTrial®)
- Image Data Management System (IDMS aka. BDMS, TrialComplete)
- I require a client certificate (TTP)
- Deregistration of a User Access (applies to the complete DZHK infrastructure DH, LIMS, BDMS and TTP)
Clinical Data Management System (CDMS or DH, secuTrial®)
Please select the role of the user in secuTrial*
Applies only to the FAIR-HF2 study
- blinded
- unblinded
Applies only to the FAIR-HF2 study
- blinded
- unblinded
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- Clinical Investigator
  Clinical Investigator: User may create new patients in the Clinical Data Management System. User may create new visits as well as documenting and editing patients data. Users may sign forms and approve them for further quality assurance (review A).
- Export
  Export: User has only viewing and reading rights of forms and the export right.
- Monitor (all sites)
  Monitor: User can create queries, which will be answered and closed after the query has been resolved.
- Study Nurse
  Study Nurse: User may create new patients in the Clinical Data Management System. User may create new visits as well as documenting and editing patients data. User may declare the data capture of a form as complete and approve it for further review. (DEC: Data Entry Complete).
- Observer (all sites)
  Observer: User is allowed to open the patient's visit schedule and read the patient's data.
- Inactive
  De-registration of the users access.
- Other
  Other: Additional roles can be requested such as blinded, unblinded, data manager, study center, pharmacovigilance
Request more roles here

Additional roles can be requested such as blinded, unblinded, data manager, study center, pharmacovigilance
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Zentrum_intern?
- Zentrum ist ein Internes
Ist per Default ausgewählt, aber wenn in der Datenbank für das ausgewähltes Zentrum nichts hinterleg ist, wird hacken entfernt
- Biomaterial collection (only applies to external DZHK sites)
Laboratory Information Management System (LIMS, CentraXX)
Please select the role of the user in CentraXX.*
- Study Nurse
  Study Nurse: User may prepare sampling, print labels, process document, provide information on blood collection/urine delivery.
- MTLA
  MTLA: User may document sample receipt, centrifugation, aliquoting, storage, retrieval and transfer of samples and create new storage structures for sample storage
- Local investigator
  local study leadership: Access to the reporting of biobanking for the authorized studies at the study site.
- Central investigator
  central study administration: Access to the reporting of biobanking for the authorized studies of all active recruiting study sites.
- Inactive
  De-registration of the users access.
Image Data Management System (IDMS aka. BDMS, TrialComplete)
Please select the role of the user in TrialComplete.*
- Document Uploader
  Document Uploader: study site role – may upload DICOM data (images, biosignals) in DICOM format.
- Imaging Quality Check (CoreLab)
  Imaging Quality Check (CoreLab): CoreLab role - performs quality checks and can further clean DICOM headers
- Imaging Reader (CoreLab)
  Imaging Reader (CoreLab): CoreLab Role - May view image data.
- Imaging Analyst (CoreLab)
  Imaging Analyst (CoreLab): CoreLab role – user downloads image data; fills out and signs eCRFs; submits queries on image data to study sites.
- Monitor
  Monitor: User can create queries, which will be answered and closed after the query has been resolved.
- Coordinating Investigator (study site)
  Coordinating Investigator (Study Center): study site – has all rights of the other roles and is allowed to view AMG/MPG data overviews.
- Inactive
  De-registration of the users access.
Client-Certificate
Client certificate
- I need a new client certificate
- Please send client certificates again
- My client certificate has expired and needs to be renewed
Bitte tragen Sie ihre Endgerät Daten ein*
Your external IP address Computer name MAC address (optional)
(click here to see your external IP address)
Note: A client certificate is required for participant creation and processing of consent forms.

Einwilligung*
We attach great importance to data protection. Your personal data will be collected and processed in compliance with the applicable data protection regulations,in particular the EU General Data Protection Regulation (GDPR), to the extent necessary for the implementation of the project/study. You can find more information about our data protection regulations on DZHK.de under the menu item "Imprint and Data Protection". You hereby confirm that you consent to the processing of your personal data under the above premises.
I have read the data protection notice and confirm that I agree to the processing of my personal data under the above premises. *

NOTES AND COMMENTS

Hinweise und Bemerkungen

KONTAKT
Deutsches Zentrum für Herz-Kreislauf-Forschung eV
DZHK-Geschäftsstelle
Potsdamer Straße 58
10785 Berlin-Mitte
E-Mail: infrastruktur@dzhk.de

erstellt durch die Unabhängige Treuhandstelle Greifswald
Email
Dieses Feld dient zur Validierung und sollte nicht verändert werden.