ACTRI BMI - Florence Service Request Form Logo
  • ACTRI Biomedical Informatics (BMI) - Florence Service Request Form

  • Florence eRegulatory

  • User Access-related services can only be requested by Users' Manager!

    • --- 5.1 Florence eReg - Create Study   
    • Create Study

    • Currently only ACTRI or MCC managed studies will be built. Please contact actri-florence@health.ucsd.edu if you have any questions.

    • Note: There will be a one-time charge of $100 if the study becomes active. Please provide the necessary chartstring information further below.

    • Note: Setting up the eTMF study in Florence will incur a cost of $256, which covers 2 hours of recharge time. Please provide the appropriate recharge account information so we can proceed with the setup.

    • --- 5.2 Florence eReg - Update Study 
    • Update Study

    • --- 5.3 Florence eReg - Department Header 
    • Grant/Update Department User Access

    • --- 5.4 Florence eReg - External Monitor Header 
    • Grant/Update External Monitor User Access

    • --- 5.5 Florence eReg - Study-Specific Header 
    • Grant/Update Study-Specific User Access

    • --- 5.6 Florence eReg - Grant/Update Specifics 
    • Note: This section MUST be filled out by the users' manager!

    • Cannot proceed until training has been completed.

    • Please download the User Access Excel spreadsheet here, fill in the required information for each user, and upload the completed file below.

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    • --- 5.7 Florence eReg - Remove User Access 
    • Remove User Access

      Note: This section MUST be filled out by the users' manager!

    • Please download the appropriate User Access Excel spreadsheet here, fill in the required information for each user, and upload the completed file below.

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    • --- Study Information Section 
    • Study Information

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    • --- PI Section 
    • PI Information

    • If you are not an ACTRI member yet, please click here to review membership eligibility criteria and submit your application. Once submitted, please select the applicable membership level from the above options to proceed.

    • --- Contact Person Section 
    • Contact Person/Submitter Information

    • --- Recharge Section 
    • Recharge Information

      Please provide valid fund manager and OFC chartstring information for recharge purposes.

      Click here to review current ACTRI recharge rates.

    • Providing incorrect or incomplete OFC chartstring information will require further clarification and delay the process! Contact your fund manager or use the chartstring verification tool (requires VPN connection) to ensure chartstring accuracy prior to submission.

    • --- Reporting Section 
    • Additional Information


    • Industry-sponsored studies are not eligible to receive voucher support. To proceed with your service request, please scroll up to the ACTRI Voucher Program section and unselect 'Yes'.


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    • --- Submission Section 
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