CCS Reading Center Data Submission Form

All Reading Centers or Data Repositories collecting data in MWCCS need to submit their plan using this form. As part of this proposal, investigators are asked to:

1. Answer online contact/admin, study design, and data submission questions.

2. Upload a Data Plan summarizing the proposed data submission plan. Click here to download the Data Plan template. Please use the following file naming system when uploading your Data Plan: DP_LastName_MMDDYY

If you have any questions about the process, please contact us at MWCCS@jhu.edu

Section A: Study Overview & Contact Information

Name of Study *

Study Lead Investigator Name *

First Name Last Name

Study Lead Investigator Email *

example@example.com

Name of Reading Center

Name of institution or lab generating data

Name of Primary Contact at Reading Center

First Name Last Name

Reading Center Contact Email

example@example.com

Upload Data Plan here. Note: Please use the following file naming system when uploading your Data Plan: DP_LastName_MMDDYY *

Browse Files

Upload Participant Letter Template here (if applicable)

Browse Files

Section B: Study Design

Proposal includes *

All MWCCS sites Select sites

Sites included in proposal, indicate centers (select all that apply OR if applicable, for ease, select option for all historic MACS-only or all historic WIHS-only sites)

Sites AirTable Ready

Does this project involve any additional participant burden (select all that apply)? *

No new/additional participant burden Additional specimen collection(s) New questionnaire(s) Requires separate study visit New procedures

Addl Partic Burden AirTable Ready

Does this project involve any additional MWCCS staff burden (select all that apply)? *

No new/additional staff burden New questionnaire(s) Separate informed consent Requires separate study visit Additional specimen collection(s) New procedures Staff training required Participant result letter given

Addl Staff Burden AirTable Ready

What study visit will this data be collected? *

V101 V102 V103 V104 V105 V106 Requires separate study visit To Be Determined

Reading Center/Data Repository Data Submission

Section A: Study Overview & Contact Information

Section B: Study Design

Section C: Data Transfer