Biologic Specimen and Data Repository Information Coordinating Center
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Data Request Form

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Request Identifier

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Requestor Information

Support Information

Request Details

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A brief overview of your research needs.
Include the participant inclusion/exclusion criteria, expected study visit periods, key analytic variables, primary and secondary outcome measure, follow-up period (if applicable), and intended statistical methods. Inadequately described requests may be deferred until a complete description is included.
Study data must be maintained in a secure and controlled environment
A "Yes" response defines this as a "Commercial Purpose" request.