ࡱ> []Z jbjbj 4L|| MZZ844`jR:"\\\7L$$ |#^77\\p\\\k6H+^00`#t##`#Z z:  Research Access to Notes Registration Form Any research project carried out within the Oxford University Hospitals Trust is registered with the Research and Development Team before it commences. We keep a central database of all research activity which is used to report within the Trust. We confirm that appropriate access is granted to medical records for authorised research projects. PROJECT DETAILS Research Title Substantive employer:Lead Investigator at OUH (if applicable)  N/A  FORMCHECKBOX R&D Reference:Ethics Reference:  Please tick type of access required OUH Researcher  FORMCHECKBOX Research Letter of Access  FORMCHECKBOX Other  FORMCHECKBOX  RESEARCHERS DETAILS Name  Contact telephone number and bleep Name and contact details of research supervisor (if applicable) Tel: N/A  FORMCHECKBOX  Please sign confirming compliance with the OUH policy Health Records Management Policy Copy with form  HYPERLINK "http://orh.oxnet.nhs.uk/InformationGovernance/Document%20Library/Policies%20and%20Procedures/Health%20Records%20Managment%20Policy.pdf" http://orh.oxnet.nhs.uk/InformationGovernance/Document%20Library/Policies%20and%20Procedures/Health%20Records%20Managment%20Policy.pdf Signature of researcher: R&D contact Please return to R&D for signoff Research Governance Administrator R&D Department, Joint Research Office, Block 60, Churchill Hospital, Oxford, OX3 7LJ Tel: 01865 (5) 72236/72239/72970 Date form completed Researcher to return completed form directly to Medical Records  Research Access to Notes Registration Form MEDICAL RECORDS ACCESS Notes will not be pulled for you by medical records staff. Therefore you will need to pull your own records, once your research has been registered and approved by the Research and Development Department. You will need to be PAS trained in order to check where the notes are located. Contact for training is Help Desk 22822 or Senior Library Manager 31521. To request records by phone: 911 central library 21633 Fax 21634 When you are ready to pull notes you will need: ( a list of patient hospital numbers in reverse order of the last two digits eg. Hospital number 4002288 can be located at aisle 88, section 22, record 400 ( a safe place to store the notes in if you want to remove them from the library. This must be secure, but also accessible out of hours if the notes are needed urgently ( a PAS location code to book the notes to if you remove them from the library  Thank you Research & Development Department Joint Research Office Block 60 Churchill Hospital Oxford OX3 7LJ 01865 (5) 72236/72239/72970      PAGE  PAGE 1 RAN Reg. form. 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