Forms

Complete to use our network.

Request collaboration with REACHnet by submitting the appropriate Service Request Form(s). All forms should be submitted through our online portal, Eco. Please contact the REACHnet Coordinating Center with questions. We are here to help and look forward to collaborating with you!

 


 

  • If you are interested in conducting prospective research through our network, please complete our Prospective Research Request Form. Prospective studies include observational and interventional research that requires future data. This form will give you the opportunity to describe your study proposal, needs, and collaboration interests.
  • If you are interested in conducting retrospective research through our network, please complete our Data Request Form. Retrospective studies involve the use of existing data for research. REACHnet can share both aggregate and patient-level data. When patient-level data are requested, only de-identified or limited datasets may be shared. A data use agreement between the investigator(s) and REACHnet must be executed.
  • If you would like REACHnet to perform a prep-to-research query, submit our Query Request Form. Prep-to-research queries are used to quantify the number of patients in our network that meet a particular study’s inclusion and exclusion criteria.
  • Interested in involving patients and other stakeholders in your project as advisors or co-investigators? Do you need consultation on your study proposal’s Engagement Plan? REACHnet is able to provide consultation services for many engagement needs. To learn more about our engagement services and submit a request, check out our Request for Engagement Services.

For more information on Eco, please click here.

6-Month Progress Report

After 6 months of working with REACHnet, please keep in touch by describing study progress, modifications, and future plans

Acknowledgements Form

Investigators are required to acknowledge REACHnet support and cite results acquired from REACHnet data appropriately in all funding applications, presentations, and publications in accordance with guidelines found in the Acknowledgements Form.

Data Request Form

Request access to standardized clinical data from REACHnet’s partner health systems for your retrospective study.

Prospective Research Request Form

Enhance your prospective research proposal or funding application by partnering with REACHnet.

Query Request Form

Determine how REACHnet’s patient population and standardized clinical data can meet your study’s data needs

Request for Engagement Services

Use this form to receive consultation or connect with our network to meaningfully involve stakeholders in your research.