OPTIMA User Access Form

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OPTIMA User Access Form

Please complete the below request if you need to add someone to the OPTIMA online application.

Name of person making request

International Coordinating Country

Please complete this form for the personnel who will need access to the OPTIMA online application for randomisation and data entry at a recruiting Site.

If you wish to add a person to the ICC delegation log, please email OPTIMA@warwick.ac.uk

First name

Surname

email address

IP address

Site Name

Access permissions

Yes

No

Data Entry

Computer Recruitment

Read Only

Thank you for completing. WCTU will contact you once this request has been actioned.

Privacy notice

The information you provide may be shared with the OPTIMA Trial Management Group but will not be shared more widely. The above information will be sent to OPTIMA@warwick.ac.uk to allow us to process the User Access Request.

The University of Warwick is the Data Controller of any information you have entered on this form and is committed to protecting the rights of individuals in line with Data Protection Legislation. The University's Data Protection webpages provide further information on your rights and how the University processes personal data. If you wish to submit a data subjects rights request, make a complaint or report a suspected personal data breach, please contact the University’s Data Protection Officer by email at infocompliance@warwick.ac.uk.

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