Application for Data Access – NIDA Center for Genetic Studies

This field is for validation purposes and should be left unchanged.

Name(Required)

First Last

Email Address(Required)

Enter Email Confirm Email

Organization/Sponsoring Institution(Required)

Organization Type(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

FAX

Cover Letter(Required)

Please provide a one-page description of the study and purpose of access request written on the letterhead of the sponsoring institution at which the research will be conducted.

Accepted file types: pdf, docx, Max. file size: 256 MB.

Funding Information(Required)

Please provide the source of funding, period of support, and active/pending status.

NIH Biosketches(Required)

Please upload the biosketches of the applicant and relevant investigators and co-investigators. Use the current NIH format.

Drop files here or

Accepted file types: docx, pdf, Max. file size: 256 MB.

Facilities and Other Resources(Required)

Please use the current NIH format.

Drop files here or

Accepted file types: docx, pdf, Max. file size: 256 MB.

Distribution Agreements(Required)

Please see here for instructions. The distribution agreements must be digitally signed.

Drop files here or

Accepted file types: docx, pdf, Max. file size: 256 MB.

Billing Address(Required)

Same as the address given at the top

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Shipping Address(Required)

Same as the address given at the top

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

P.O. #

Optional

FedEx Account #

Optional

Requested Phenotypic Datasets

This allows you to request downloads of addiction-related phenotypic datasets for a given disease as described here. Please either select one or more diseases or enter request specific samples (DNA, CPLs, and so on) in the field below.

Cannabis Dependence

Cocaine Dependence

Methamphetamine Dependence

Nicotine Dependence

Opioid Dependence

Opioid-Cocaine Dependence

Polysubstance Dependence

Requested Samples

If applicable, upload the list of samples of DNA, CPLs, and so on, you are requesting. Note that CPLs are ideal for making iPSCs. See our data browser for reports of the number of subjects in various disease collections have various cell types. Contact us at data.access@nidagenetics.org if you need help determining the list of DNA samples. Alternatively, you may apply for access to just phenotypic data in the field above.

Drop files here or

Accepted file types: xlsx, xls, docx, pdf, Max. file size: 256 MB.

Human Subjects Approval(Required)

Please provide a letter from your IRB or equivalent. Some studies will require IRB approval or exemption. When IRB approval or exemption is required, applicants must document human subject approval by an Institutional Review Board (IRB or human subjects committee) constituted according to the requirements of the Dept. of Health & Human Services Office for Human Research Protections (OHRP). Applicants should note that all data and materials in the repository were stripped of all personal identifiers before they were submitted to the repository, such that no identifying information is associated with the samples. However, applicants should provide documentation of IRB review and either approval of the proposed project or exemption of the proposed project from the need for further IRB review. The IRB approval will not be required at the time the Access Request is submitted. However, neither data nor DNA samples will be released until evidence of IRB approval or exemption has been received.

Drop files here or

Accepted file types: pdf, docx, Max. file size: 256 MB.

Comments

Feel feel to provide any comments that may be helpful in reviewing your application.

CAPTCHA

Data Access Application Form