Activation Steps for European and North American Hospitals

Next Steps For European and North American Hospitals to Join the GTC

Click each step below and follow the instructions.

Obtain approval of the Data Use Agreement (DUA). Email to: members@globaltrach.org, Download instructions to the DUA:

Global Tracheostomy Collaborative Registry and Data Use Agreement Memo

Use the form below to request an invoice.

Or send and email to members@globaltrach.org with the subject REQUEST INVOICE. In the email body please include your name, institution and contact information (email and physical address).
Further details and payment instructions will be sent to you once you request an invoice.

Fill out, scan, and email the signed Patient Health Information form and the signed Data Use Agreement (DUA) to: members@globaltrach.org

Patient Health Information Form
For UK/Europe Only: Each new member of the GTC Quality Improvement Database is required to notify the collaborative, upon joining, that their data collection efforts are within the scope of their local ethics committee or institutional review board. In the UK, this is likely to be your local ‘Caldecott Guardian’.
User name/password for members portal access will be emailed to the primary contact and hospital champion(s).

Hospital Members Portal (requires sign in)
This does not include access to the GTC REDCap Database, which will be sent once payment is received.

User name/password will be provided to identified individual(s) who require access to the GTC REDCap Database.

Institution Name
PRIMARY CONTACT Indentify the person who will communicate with GTC staff to guide your institution through the sign-up process.
Full Name	Position/Discipline	Email	globaltrach.org Yes	REDCap Yes
HOSPITAL CHAMPIONS(S) Identify who will be the leader(s) in implementing the GTC at your institution.
Full Name	Position/Discipline	Email	globaltrach.org	REDCap
			Yes	Yes
			Yes	Yes
			Yes	Yes
			Yes	Yes
ADDITIONAL USERS If there are any other people you would like to have access to the globaltrach.org hospital portal or REDCap, please identify them below.
Full Name	Position/Discipline	Email	globaltrach.org	REDCap
			Yes	Yes
			Yes	Yes
			Yes	Yes
			Yes	Yes
			Yes	Yes
			Yes	Yes
Captcha

REQUEST INVOICE
Contact Name (Include Salutation)	Contact's Title
Contact's Email	Contact's Phone Number
Institution Name	Institution Address
Captcha (all fields required)