The code block below illustrates how one might use # and // as comments in your logic and calculations.

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REDCap User account and password request form February 2024

Community Health Boards (CHB) will report Local Public Health Act finance, staffing, and performance measures for calendar year 2023 into REDCap (Research Electronic Data Capture) by March 31, 2024. REDCap is a secure, web-based application that will allow Community Health Boards to access their own data after reporting closes.

To use REDCap to report this data, each individual in your CHB who has reporting responsibilities will need a REDCap user account and password. We anticipate that most CHBs will need five or fewer accounts (note: all CHS administrators and Public Health directors will automatically receive a REDCap user account and password for all reporting areas, and do not need to enter their names below).

Please carefully review the names and email addresses to ensure they have been entered correctly and that there are no typos.

Complete this form for the staff that need access to REDCap by February 9, 2024.

If you have any questions, please contact Ghazaleh Dadres at ghazaleh.dadres@state.mn.us

Please select the name of your CHB:

* must provide value

Please list the names and email addresses of individuals in your community health board who need REDCap user accounts and passwords (note: all CHS administrators and Public Health directors will automatically receive a REDCap user account and password and do not need to enter their name below). Select all areas of reporting for which the individuals listed below need access (Check all that apply).

Participants	Name	Email Address	Area of participation
Staff member 1
Staff member 2
Staff member 3
Staff member 4
Staff member 5

If you have more than 5 staff members who need access to REDCap, please list the name and email address of these individuals in the box below, indicating which areas (staffing, finance or performance measures) they need to access. Leave blank if you do not have any additional staff.

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Please list the names and emails of individual(s) in your community health board who need REDCap user account and passwords to update your community health board's contact information throughout the year. CHS administrators will automatically receive a REDCap user account and password. If there is no one else other than the CHS administrator who will update contact information, leave this blank.

Staff Member	Staff name	Email
Staff member 1
Staff member 2

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