Request Access to EpicCare Link for Sponsor Monitor

Welcome!

Use this online form to request access to UT Health San Antonio's instance of EpicCare Link for Research Sponsor's monitors.

Non-Cancer Related Clinical Trials Only
Requests from UTHealthSA investigators and research team members Only
Requests should be submitted at least 30 calendar days before the visit start date.

What information do you need to complete the request form?

Basic study information (title, tracking number, etc.)
Monitor's information (name, email, current EpicCare Link creditials if applicable)
Monitoring start and end dates

Save & Return - see the instructions at the bottom of the form on how to save your work and return later to complete the submission.

Security -- This questionnaire uses UT Health San Antonio's instance of REDCap. REDCap is a secure web authentication application that is HIPAA compliant. Access is through centralized two factor authentication, all data are encrypted meeting FISMA security standards, physical, network, and computer security is third-party monitored and enforced through the university's Information Assurance Division.

UTHSCSA Research Study Staff Responsible for Access

Name		Dept
Phone		Email

Monitor's Information

Name		Employer
Phone		Email

Study Information

Title

Sponsor

Sponsor's Study ID

UTHSA Site PI

CTMS #

Visit Information

Type
Start Date		End Date

Warning - Monitoring visits should be submitted at least 30 days prior to the start date. Your start date is ______ days from today.

Exceptions are possible.

Important Information

Your on-site visit request is for ______ consecutive days.

Additional security measures including a background check are required for on-site visits longer than three days. The research team will provide guidance prior to the start of the visit.

Important Information

Your remote visit request is for ______ consecutive days.

Remote visits longer than five days are not allowed. Please adjust the start/end dates.

Yes No

reset

Yes No

reset

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Save & Return
You do not have to complete the form in one session.
To save your work and return later, click on the "Save & Return Later" button located at the bottom of each page.

Two Important Steps when using Save & Return
To return to the survey, you will need both the Survey Link and your Return Code.

Return Code is required, please write down the value

Survey Link
You may bookmark this page to return later,
-or-
You can have the survey link emailed to you by providing your email address in the space provided

View equation

You have selected an option that triggers this survey to end right now. To save your responses and end the survey, click the button below to do so. If you have selected the wrong option by accident and do not wish to leave the survey, you may click the other button below to continue, which will also remove the value of the option you just selected to allow you to enter it again and continue the survey.

The response has now been removed for the last question for which you selected a value. You may now enter a new response for that question and continue the survey.