VelosCT User Request Form

VelosCT is the Clinical Trial Management System implemented at BMC for BMC/BUMC shared clinical research (CR) services. VelosCT is used to manage CR financial and administrative activities, and to ensure compliant CR billing of prospective protocol-related clinical services.

Note: Please complete the form on the next page. Once access is granted, please work with your teams' study creators and/or Clinical Trial Office [CTO@bmc.org] to be added to your specific study(s) in VelosCT.

Is this request for you or on behalf of someone else?

Your credentials (The one who fills the form and will get a confirmation email)

Your Name:

Your Email:

I attest that the person whom the VelosCT access is being requested has completed the VelosCT Training

Training is required before access to VelosCT can be granted. Visit the VelosCT Training section of the systems page for details.

Please continue to submit this form so that we can expedite VelosCT access once training is confirmed. This form will be routed to the Clinical Trials Office (CTO@bmc.org) who will inform RIS upon training completion.

If the matter is time-sensitive, please indicate in the Comments field below.

User Details:

Name:

Job Type:

Please specify "Other":

Street Address:

City:

State

Country

Zip/Postal Code:

Department & Role

Department/Section (Please start typing):

Role:

Employer:

BMC credentials

BMC Username:

BMC Email:

BU credentials

BU Username:

BU Email:

Will you be using VelosCT to work exclusively on BMC studies, BU studies or both?:

Do you have a BMC login?:

The form responses suggest that the new user is employed by BMC and/or is working on BMC studies in VelosCT. If either is the case, then a BMC username and email is required before being able to access VelosCT. Click here for instructions on how to obtain BMC credentials.

Please continue to submit this form so that we can expedite VelosCT access once BMC credentials are confirmed. If the matter is time-sensitive, please indicate in the comments field below.

Please enter your BMC credentials:

Username:

Email:

Comments: