This form is to request a new account or manage an existing eReg Account for University of Michigan Employees.
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New Account Request for eReg
Modification to an existing eReg Account
Deativation of an eReg Account
Are you filling this form out for yourself or on someone else's behalf?
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Myself
Someone else
You answered that you are filling this request out on someone else's behalf.
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First Name
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Last Name
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Email Address
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Uniqname
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Affiliation
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Please describe your other CTSU affiliation:
Are you a direct employee of MCTSU or OCTSU?
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Yes
No
Please select your primary Department, Center, School or College:If you are employed by MCTSU or OCTSU directly, please select "Other".
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Anesthesiology Biological Chemistry Biomedical Engineering - MS Cardiac Surgery College of Engineering Coll of Lit, Science & Arts College of Pharmacy Dermatology Dermatology Emergency Medicine Family Medicine Human Genetics Int Med - Allergy Int Med - Cardiology Int Med - Gastroenterology Int Med - General Medicine Int Med - Geriatrics & Palliative Med. Int Med - Hematology/Oncology Int Med - Hospital Medicine Int Med - Infectious Diseases Int Med - Institute of Gerontology Int Med - MI Diabetes Research Training Int Med - MI Metabolical & Obesity Center Int Med - Metabolism, Endo & Diabetes Int Med - Mich Comprehen Diabetes Center Int Med - Molecular Med & Genetics Int Med - Nephrology Int Med - Pulmonary/Critical Care Int Med - Rheumatology Learning Health Sciences Mary H Weiser Food Allergy Ctr MSA ULAM Faculty Microbiology and Immunology Neurology Neurosurgery Obstetrics/Gynecology Office of Patient Experience Ophthalmology & Visual Sciences Orthopaedic Surgery Otolaryngology Pathology Pediatrics - Adolescent Medicine Pediatrics - Ambulatory Care Pgm Pediatrics - Biochem Gen./Metab. Pediatrics - Cardiology Pediatrics - Developmental Behavioral Pediatrics - Endocrinology Pediatrics - Gastroenterology Pediatrics - General Services Pediatrics - Genetics Pediatrics - Hematology/Oncology Pediatrics - Hospitalists Pediatrics - Infectious Diseases Pediatrics - Intensive Care Pediatrics - Neonatal/Perinatal Pediatrics - Nephrology Pediatrics - Neurology Pediatrics - Pediatric & Communicable Diseases Pediatrics - Primary Care Pediatrics - Psychology Pediatrics - Pulmonary Medicine Pediatrics - Rheumatology Pharmacology Physical Medicine & Rehabilitation Psychiatry Radiation Oncology Radiology School of Dentistry School of Kinesiology School of Nursing School of Public Health School of Social Work Surgery - Acute Care Surgery Surgery - Colorectal Surgery Surgery - Endocrine Surgery Surgery - Gastrointestinal Surgery - Minimally Invasive Surgery - Oral & Maxillofacial Surgery Surgery - Pediatric Surgery Surgery - Plastic Surgery Surgery - Surgical Oncology Surgery - Thoracic Surgery Surgery - Transplant Surgery Surgery - Vascular Surgery Urology Other
If Other, please type in your primary Department, Center, School or College:
Do you have a secondary appointment in additional Departments, Centers, Schools, or Colleges where you perform research?
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Yes
No
Please select the additional Departments, Centers, Schools, or Colleges where you have a secondary appointment:
If Other, please type in your additional Secondary Department(s):
Current Job Title
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Do you have a UM Level 2 Account?Hint: If you have an @med.umich.edu email address or have access to OnCore or MiChart, you have a Level 2 Account.
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Yes
No
Below is a list of roles avaiable in eReg. Please review this list carefully to answer the next question.
Role Description of Role Principal Investigator Ability to view contact records and organization records. View the protocol, staff and their delegated tasks, and documents/URLs for protocols to which PI is assigned This role is reserved for Principal Investigators. Includes the Signer role. UM Regulatory Coordinator Ability to do various tasks for protocols, such as view contact records, manage/route staff credentials, adjust staff delegated tasks, manage protocol staff, view/edit protocol documents/URLs, create/view review sessions, and manage subjects. View SOPs. Staff in this role typically manage the Regulatory Binder. Includes Signer role. Signer Ability to review and sign documents. Staff in this role only need to sign essential research documents such as the tasks assigned on the Delegation of Authority UM Multisite CoordinatorNote: Only for OCTSU Employees Ability to manage multi-site protocols, such as view contact records, manage/route staff credentials, adjust staff delegated tasks, create multi-site protocols, manage participating sites, manage protocol staff, and view/edit protocol documents/URLs. View SOPs and add/edit Department-specific SOPs. This role is reserved for multi-site coordinators. Includes Signer role Reviewer Ability to view any review session to which the user has been assigned as a reviewer. Staff in this role are monitoring or auditing records.
What eReg role best aligns to the work you will do in the eReg Application based on the descriptions above?You may only select one role per request. If you need additional roles, please complete a second request form.
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UM Regulatory Coordinator
Principal Investigator
Signer
Reviewer
UM Multi-Site Coordinator (Note: Only for OCTSU Employees)
Administrative Roles
Have you been informed by your Manager or the eReg Support Team that you will require an administrative role in eReg?
**If you have not been identified as someone who requires additional permissions or are unsure, please answer No.**
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Yes
No
Administrative Roles**If you have not been identified as someone who requires additional permissions, please leave this section blank.** There are three roles in eReg that will be limited to team members who require the additional permissions to perform specific tasks in eReg. These roles are reserved for pre-identified team members.
Role Description UM Organization Management: Ability to manage Organizations within eReg such as upload regulatory documents to lab and IRB Organizations UM SOP Management: Ability to add SOPs, manage department-based SOP documents, and manage SOP Review Sessions UM Regulatory Manager Ability to do various tasks for protocols, such as view contact records, manage/route staff credentials, adjust staff delegated tasks, create protocols, manage protocol staff, view/edit protocol documents/URLs, create/view review sessions, and manage subjects.
View SOPs.
Staff in this role typically manage other Study Coordinators or are a Lead Study Coordinator and may also manage the Regulatory Binder.
This role includes all the permissions of a UM Regulatory Coordinator and Signer.
What is your current primary CTSU affiliation?
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Are you transferring to a new Department, Center, School, or College?
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Yes
No
Please select ALL Departments, Centers, Schools, and Colleges you need to be affiliated with:
If Other, please type in the NEW Department, Center, School or College:
Do you need to add or remove CTSU Affliation?
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Yes
No
What CTSU(s) do you need added?
What CTSU(s) do you need removed?
Do you need to change your eReg role or permissions?
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Yes
No
Please review the list of roles and descriptions below to answer the next question:
Role Description of Role Principal Investigator Ability to view contact records and organization records. View the protocol, staff and their delegated tasks, and documents/URLs for protocols to which PI is assigned This role is reserved for Principal Investigators. Includes the Signer role. UM Regulatory Coordinator Ability to do various tasks for protocols, such as view contact records, manage/route staff credentials, adjust staff delegated tasks, manage protocol staff, view/edit protocol documents/URLs, create/view review sessions, and manage subjects. View SOPs. Staff in this role typically manage the Regulatory Binder. Includes Signer role. Signer Ability to review and sign documents. Staff in this role only need to sign essential research documents such as the tasks assigned on the Delegation of Authority UM Multisite CoordinatorNote: Only for OCTSU Employees Ability to manage multi-site protocols, such as view contact records, manage/route staff credentials, adjust staff delegated tasks, create multi-site protocols, manage participating sites, manage protocol staff, and view/edit protocol documents/URLs. View SOPs and add/edit Department-specific SOPs. This role is reserved for multi-site coordinators. Includes Signer role Reviewer Ability to view any review session to which the user has been assigned as a reviewer. Staff in this role are monitoring or auditing records. UM Organization Management* Ability to manage Organizations within eReg such as upload regulatory documents to lab and IRB Organizations Reserved for pre-identified individuals UM SOP Management* Ability to add SOPs, manage department-based SOP documents, and manage SOP Review Sessions Reserved for pre-identified individuals UM Regulatory Manager* Ability to do various tasks for protocols, such as view contact records, manage/route staff credentials, adjust staff delegated tasks, create protocols, manage protocol staff, view/edit protocol documents/URLs, create/view review sessions, and manage subjects. View SOPs. Staff in this role typically manage other Study Coordinators or are a Lead Study Coordinator and may also manage the Regulatory Binder. Includes all the permissions of a UM Regulatory Coordinator and Signer. Reserved for pre-identified individuals
*Roles by invitation only
What eReg role(s) do you need added?
What eReg role(s) do you need to remove?
First Name of person whose account needs to be deactivated
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Last Name of person whose account needs to be deactivated
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Uniqname associated with account to be deactivated
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What date should the account be deactivated?
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