What is the name of the institution or organization for which you are requesting the Data Use and Registration Agreement (DURA)?
* must provide value
Does your institution have a website?
* must provide value
Yes
No
Please provide the URL of the home webpage of your institution's website.
* must provide value
What country is the headquarters of the institution you are affiliated with located in?
* must provide value
Afghanistan Åland Islands Albania Algeria Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas (the) Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia (Plurinational State of) Bonaire, Sint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory (the) Brunei Darussalam Bulgaria Burkina Faso Burundi Cabo Verde Cambodia Cameroon Canada Cayman Islands (the) Central African Republic (the) Chad Chile China Christmas Island Cocos (Keeling) Islands (the) Colombia Comoros (the) Congo (the Democratic Republic of the) Congo (the) Cook Islands (the) Costa Rica Côte d'Ivoire Croatia Cuba Curaçao Cyprus Czechia Denmark Djibouti Dominica Dominican Republic (the) Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini Ethiopia Falkland Islands (the) [Malvinas] Faroe Islands (the) Fiji Finland France French Guiana French Polynesia French Southern Territories (the) Gabon Gambia (the) Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Holy See (the) Honduras Hong Kong Hungary Iceland India Indonesia Iran (Islamic Republic of) Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea (the Democratic People's Republic of) Korea (the Republic of) Kuwait Kyrgyzstan Lao People's Democratic Republic (the) Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands (the) Martinique Mauritania Mauritius Mayotte Mexico Micronesia (Federated States of) Moldova (the Republic of) Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands (Kingdom of the) New Caledonia New Zealand Nicaragua Niger (the) Nigeria Niue Norfolk Island North Macedonia Norway Oman Other Pakistan Palau Palestine, State of Panama Papua New Guinea Paraguay Peru Philippines (the) Pitcairn Poland Portugal Qatar Réunion Romania Russian Federation (the) Rwanda Saint Barthélemy Saint Helena, Ascension and Tristan da Cunha Saint Kitts and Nevis Saint Lucia Saint Martin (French part) Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten (Dutch part) Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands South Sudan Spain Sri Lanka Sudan (the) Suriname Svalbard and Jan Mayen Sweden Switzerland Syrian Arab Republic (the) Taiwan (Province of China) Tajikistan Tanzania, the United Republic of Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Türkiye Turkmenistan Turks and Caicos Islands (the) Tuvalu Uganda Ukraine United Arab Emirates (the) United Kingdom of Great Britain and Northern Ireland (the) United States Minor Outlying Islands (the) United States of America (the) Uruguay Uzbekistan Vanuatu Venezuela (Bolivarian Republic of) Viet Nam Virgin Islands (British) Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe
Please provide the name of the country
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What state or territory is the headquarters of your institution located in?
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Alabama Alaska Arizona Arkansas American Samoa California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Trust Territories Utah Vermont Virginia Virgin Islands Washington West Virginia Wisconsin Wyoming
Provide the five-digit Zip Code of the headquarters of your institution.
* must provide value
Ex.12345
Is your institution a multi-national company?
* must provide value
Yes
No
A multi-national company is any corporation that is registered and operates in more than one country at a time.
What is the first (given) name of the signing official?
* must provide value
What is the last (family) name of the signing official?
* must provide value
What is the signing official's institutional email address?
* must provide value
What is the signing official's phone number?
* must provide value
For non-U.S. phone numbers, please include the country code followed by the city code and local phone number.
What is the signing official's role/job title?
* must provide value
What is your first (given) name?
* must provide value
What is your last (family) name?
* must provide value
What is your institutional email address?
* must provide value
i.e. school or company email address such as name@institution.org
What is your phone number?
For non-US phone numbers, please include the country code followed by the city code and local phone number.
What is your role/job title at the institution for which you are requesting the DURA?
* must provide value
How did you learn about the All of Us Researcher Workbench? (check all that apply)
Please specify who who gave this activity, presentation, or event.
What was the date of this activity, presentation, or event?
Today D-M-Y If you don't remember the exact date of the presentation, please guess the date to the best of your ability.
Did you learn about the All of Us Researcher Workbench from any of these program partners?
All of Us Research Program Staff
All of Us Evenings with Genetics Research Program, Baylor College of Medicine, Department of Molecular and Human Genetics
American Association on Health and Disability (AAHD)
American Indian Science and Engineering Society (AISES)
Asian Health Coalition
CTSA/PACER Community Network
Data and Research Center (DRC)
Delta Research and Educational Foundation (DREF)
FiftyForward (Senior Citizens, Inc.)
IGNITE Northwell Health, Feinstein Institute for Medical Research
Marshfield Clinic Research Institute
National Alliance for Hispanic Health (NAHH)
National Baptist Convention, USA, Inc.
National Latino Network (NLN) for Precision Medicine and Health Disparities
Network of the National Library of Medicine (NNLM)
Pyxis Partners
All of Us Researcher Academy/RTI International
PRIDEnet - Stanford University
Scripps Research Institute
University of Arizona - Banner Health All of Us Research Program
University of Utah
Other
None of the Above
All of Us Research Program Staff
All of Us Evenings with Genetics Research Program, Baylor College of Medicine, Department of Molecular and Human Genetics
American Association on Health and Disability (AAHD)
American Indian Science and Engineering Society (AISES)
Asian Health Coalition
CTSA/PACER Community Network
Data and Research Center (DRC)
Delta Research and Educational Foundation (DREF)
FiftyForward (Senior Citizens, Inc.)
IGNITE Northwell Health, Feinstein Institute for Medical Research
Marshfield Clinic Research Institute
National Alliance for Hispanic Health (NAHH)
National Baptist Convention, USA, Inc.
National Latino Network (NLN) for Precision Medicine and Health Disparities
Network of the National Library of Medicine (NNLM)
Pyxis Partners
All of Us Researcher Academy/RTI International
PRIDEnet - Stanford University
Scripps Research Institute
University of Arizona - Banner Health All of Us Research Program
University of Utah
Other
None of the Above
Please name the other program partner.
Provide any additional information regarding your DURA request (Optional).
Thank you for completing your request for an All of Us Researcher Workbench Institutional Data Use and Registration Agreement to be initiated between Vanderbilt University Medical Center and your institution. Please select "Submit" below and we will begin processing your request. You can reach out to aoudurasupport@vumc.org with further questions.
Who gave this activity, presentation, or event?
What is the nature of your request?
* must provide value
I do not have access to the Researcher Workbench and need my institution to sign a Data Use and Registration Agreement.
I already have access to the Registered Tier and would like to appeal to my institution to sign the Controlled Tier Rider.
I do not have access to the Researcher Workbench and need my institution to sign a Data Use and Registration Agreement.
I already have access to the Registered Tier and would like to appeal to my institution to sign the Controlled Tier Rider.
If you select "I already have access to the Registered Tier and would like to appeal to my institution to sign the Controlled Tier Rider", the survey will end. A pop up will appear and you can select "end survey" to save your response. We will reach out to your pre-existing institutional contact, so no need to provide an additional contact. Thank you!
Are you affiliated with a US-based academic institution, government entity, healthcare institution, or non-profit?
Yes
No
Thank you for expressing your interest in the Controlled Tier. We will reach out to your institutional contact regarding your request in the next 3 business days. This process may take longer than expected depending on the institution's contracting office. If you have any follow-up questions, feel free to reach out to support@researchallofus.org.
Do you have a contact from your institution who can either sign an agreement or facilitate signing an agreement by connecting the All of Us Access Team with a signing official from your institution?
* must provide value
Yes No
A signing official is a person who is authorized to sign contracts on behalf of your institution OR someone who can connect the All of Us Access Team with the correct authorized person (e.g., an administrative officer, contracting officer, or sponsored programs administrator for your organization).
If you do not have a contact who can sign an agreement on behalf of your institution, please work with your institution to identify someone who can assist. Once you have their name, title, email, and phone number, please come back and complete this survey. Thank you for your interest!
Based on the definitions provided above, is your institution an academic institution, health care institution, not-for-profit organization, or government entity?
* must provide value
Yes
No
At this time, only researchers from academic institutions, health care institutions, not-for-profit organizations, and government entities are eligible to request Data Use and Registration Agreements (DURAs) to access the All of Us Researcher Workbench. While we are working to expand access, please subscribe to our newsletter by scrolling down to the bottom of this page for program updates and announcements. For any questions, please reach out to aoudurasupport@vumc.org.
Although you cannot request a DURA at this time, we would like to understand who is interested in the All of Us Researcher Workbench and contact them when we expand access. If you are interested, we ask that you provide the following details below.
What is the name of the institution that you are currently affiliated with?
What country is the headquarters of the institution you are affiliated with located in?
Afghanistan Åland Islands Albania Algeria Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas (the) Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia (Plurinational State of) Bonaire, Sint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory (the) Brunei Darussalam Bulgaria Burkina Faso Burundi Cabo Verde Cambodia Cameroon Canada Cayman Islands (the) Central African Republic (the) Chad Chile China Christmas Island Cocos (Keeling) Islands (the) Colombia Comoros (the) Congo (the Democratic Republic of the) Congo (the) Cook Islands (the) Costa Rica Côte d'Ivoire Croatia Cuba Curaçao Cyprus Czechia Denmark Djibouti Dominica Dominican Republic (the) Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini Ethiopia Falkland Islands (the) [Malvinas] Faroe Islands (the) Fiji Finland France French Guiana French Polynesia French Southern Territories (the) Gabon Gambia (the) Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Holy See (the) Honduras Hong Kong Hungary Iceland India Indonesia Iran (Islamic Republic of) Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea (the Democratic People's Republic of) Korea (the Republic of) Kuwait Kyrgyzstan Lao People's Democratic Republic (the) Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands (the) Martinique Mauritania Mauritius Mayotte Mexico Micronesia (Federated States of) Moldova (the Republic of) Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands (Kingdom of the) New Caledonia New Zealand Nicaragua Niger (the) Nigeria Niue Norfolk Island North Macedonia Norway Oman Other Pakistan Palau Palestine, State of Panama Papua New Guinea Paraguay Peru Philippines (the) Pitcairn Poland Portugal Qatar Réunion Romania Russian Federation (the) Rwanda Saint Barthélemy Saint Helena, Ascension and Tristan da Cunha Saint Kitts and Nevis Saint Lucia Saint Martin (French part) Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten (Dutch part) Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands South Sudan Spain Sri Lanka Sudan (the) Suriname Svalbard and Jan Mayen Sweden Switzerland Syrian Arab Republic (the) Taiwan (Province of China) Tajikistan Tanzania, the United Republic of Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Türkiye Turkmenistan Turks and Caicos Islands (the) Tuvalu Uganda Ukraine United Arab Emirates (the) United Kingdom of Great Britain and Northern Ireland (the) United States Minor Outlying Islands (the) United States of America (the) Uruguay Uzbekistan Vanuatu Venezuela (Bolivarian Republic of) Viet Nam Virgin Islands (British) Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe
What is your institutional email?
What type of institution are you affiliated with? Check all that apply.
* must provide value
Please describe what other type of institution you are affiliated with.
Submit
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