Research Operations Custom Report Request Form

Study teams can utilize this form to request ad hoc reports from Research Operations. This form should be used for one-time ad hoc reporting not currently available and must relate to sponsored programs data. This form enables you to specify the preferred data source for your report. If no preference is indicated, Research Operations will review the request and determine the most suitable data source for you.

For clinical data needs and/or research extractions from Epic, contact the BMC Clinical Data Warehouse for Research (CDW-R). Information on CDW data, how to submit a research data request, and more is available at https://www.bmc.org/research/clinical-data-warehouse-cdw.

Report Requested By

Please describe your request and include:

· Time period for the report

· Data points required, please be as specific as possible

· Who will receive the report and its purpose

· All reports will be returned in Excel format unless other format specified in request

Do you request specific format for the reports?

YESNO (Reports will be delivered in Excel format)

Please specify the format

If you have an example report please attach to this request

Attachment

Is there a specific deadline for the report?

Please note the standard timeline for report delivery is 2-4 weeks

Please indicate which date would you like the report to be ready

If selected "Other", please specify the data source:

Contact Information