External Affiliate NetID Request Form

Please be sure that prior to completing this REDCap survey, you have submitted an "External Affiliate NetID Form" request in SPARCRequest. You will be asked to provide your SPARC request number below.

Complete this form to extend an existing External Affiliate NetID, terminate an existing one, or to request a new "External Affiliate NetID". This type of limited access NetID is appropriate for non-MUSC research staff (i.e. community partners, off-campus staff) who, for study purposes, need access to the eIRB, REDCap, CITI training, and/or SPARC Request systems. Access will be limited to these four systems.

If an MUSC email address, badge, or access to any other MUSC systems (ex. MUSC library, Epic, etc.) is needed, investigators should contact HR to obtain a traditionally sponsored MUSC NetID with all privileges.

Questions? Contact the SUCCESS Center at SUCCESS@musc.edu.

Please select one response below

* must provide value

I am requesting an extension for an existing External Affliate NetID

I am requesting termination of an existing External Affiliate NetID

I am requesting a new NetID for an External Affliliate

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Confirm Type of Access Needed

* must provide value

This affiliate will need access ONLY to one or more of the following research systems:
(1) eIRB
(2) SPARCRequest
(3) CITI Training
(4) REDCap

This affiliate will require additional access to other MUSC systems (ex. MUSC library, Epic, etc.) or an MUSC email address or badge.

reset

STOP. An external affiliate NetID will not meet your needs. You will need to contact MUSC Human Resources to obtain a traditionally sponsored NetId for your affiliate.
Please close this survey and contact HR.

SPARC Request ID # (SRID)

* must provide value

External Affiliate's First Name

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External Affiliate's Middle Name

External Affiliate's Last Name

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External Affiliate's Email Address:

* must provide value

External Affiliate's NetID

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External Affiliate's Date of Birth

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M-D-Y

Termination Request Completed by:

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Has this External Affiliate ever been issued a NetID in the past?

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Yes

I don't know

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What is the NetID previously assigned to this External Affiliate?

First name of person who will be sponsoring this affiliate NetID

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Last name of person who will be sponsoring this affiliate NetID

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Sponsor email address

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Attestation

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By signing and submitting this form, I am sponsoring an External Affiliate NetId for the individual named above so that they may access the eIRB, REDCap, CITI training, and SPARC Request systems as required for their role on this project. This External Affiliate NetId is valid for a period of one year, at which time the NetId must be re-authorized in order for continued access.

Sponsor Signature

* must provide value

Add signature

NetID assigned

Date Issued/Extended

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