Data Use Requests

Please review the Data Use and Publication
Policy before submitting a data use request.

ONLINE DATA USE FORM

Requester Information

Name

Date of Request (Enter as MM/DD/YYYY): *

Requester Email: *

Requester Institution:

Others participating in this study

Project Information

PCG study you are requesting data permission for (e.g. REG001-09): *

Do you wish to use all PCG data or specific instructions? *

All Institutions Specific Institutions

List Specific Institutions (If Applicable)

Provide a brief overview of the project: *

PCG Electronic Database

All data collected on the PCG case report forms will be included unless otherwise specified. For example, if you wish to receive follow up data only, please indicate this here.

Please note that for DICOM-RT files, the data that is included is from July 2017 to current. Requests for DICOM-RT data prior to this date will be considered a special project with a timeline of a minimum of 90 days. PCG is not able to guarantee all files can be obtained from the institutions. If medical records may be needed for your project, please contact PCG directly at hq@pcgresearch.org or call the office at (630) 836-8668. Further information will be provided.

Goal of the Project

If abstract, where would you like to present it?

Year the abstract will be presented (Enter as YYYY):

If manuscript, what journal(s) would you like to target?

Other goal for your project:

I verify that I have read and agree to abide by the current PCG Data Use and Publication Policy.

WANT TO LEARN MORE?

Contact Proton Collaborative Group (PCG) today and a member of our highly trained staff will reach out to discuss any questions you may have.