Request Form for X Hospital based on PUF ACS NSQIP

 

Please create a template request form for the X Hospital based on PUF ACS NSQIP-
Questions should be asked within the form.
First and Last Name
Role at the organization
If a student/resident, please ,Requestors will then be required to complete a brief online form to provide ACS with basic information about themselves
Please provide a description of the project that you are planning
Have you verified the variables necessary are available in NSQIP?
Have you submitted an IRB application?  (if yes, what is the number?)
How do you want the data?  Text, SAS, and SPSS
Would you like to have a meeting with someone from the NSQIP Data team regarding variables and/or your project?
If approved, you will be sent a DUA which all team members must sign.  This DUA contains the parameters around utilizing the data as well as how to required documentation regarding the data that must be included in your manuscript.

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