Sage Bionetworks Help Center
  1. Sage Bionetworks Help Center
  2. Access & Compliance Team (ACT)

GENIE Access Request

Required fields are marked with an asterisk*
Powered by Jira Service Management
{"xsrfToken":"36a11afbb0d71e400533fb32a719fc63baaa45a4_lout","branding":{"id":"8","key":"act","name":"Access & Compliance Team (ACT)","portalBaseUrl":"/servicedesk/customer/portal/8"},"helpCenterBranding":{"logoUrl":"https://api.media.atlassian.com/file/09392171-04f3-4a46-b595-dbde5f429be1/image?token=eyJhbGciOiJIUzI1NiJ9.eyJpc3MiOiI2MzNhMzIzMC1mNzYxLTQ2YjEtYWI5Ny1jMmQ3OTY1MDYzNmMiLCJhY2Nlc3MiOnsidXJuOmZpbGVzdG9yZTpmaWxlOjA5MzkyMTcxLTA0ZjMtNGE0Ni1iNTk1LWRiZGU1ZjQyOWJlMSI6WyJyZWFkIl19LCJleHAiOjE3NTM1OTAwNzYsIm5iZiI6MTc1MzU4OTQ3Nn0.HX6U0_OSb9_wpSJr-T9NOfx6WdayUjizMo9j3bHy5RM&client=633a3230-f761-46b1-ab97-c2d79650636c&mode=fit","logoId":"09392171-04f3-4a46-b595-dbde5f429be1","isLogoAvailable":true,"helpCenterTitle":"Welcome to the Help Center","sharedPortalName":"Sage Bionetworks Help Center","userInitialAnnouncementHeader":"","userInitialAnnouncementMessageWiki":"","translations":{"en-US":{"helpCenterTitle":"Welcome to the Help Center","sharedPortalName":"Sage Bionetworks Help Center","localeDisplayName":"English (United States)"}},"canEditAnnouncement":false,"siteDefaultLanguageTag":"en-US","userLanguageTag":"en-US","portalThemeColor":"#1a7dbb","helpCenterTitleColor":"#ffffff","bannerMediaApiUrl":"https://api.media.atlassian.com/file/94ae2c2d-c05c-4595-a455-aa8cd622181e/image?token=eyJhbGciOiJIUzI1NiJ9.eyJpc3MiOiI2MzNhMzIzMC1mNzYxLTQ2YjEtYWI5Ny1jMmQ3OTY1MDYzNmMiLCJhY2Nlc3MiOnsidXJuOmZpbGVzdG9yZTpmaWxlOjk0YWUyYzJkLWMwNWMtNDU5NS1hNDU1LWFhOGNkNjIyMTgxZSI6WyJyZWFkIl19LCJleHAiOjE3NTM1OTAwNzYsIm5iZiI6MTc1MzU4OTQ3Nn0.zYCVrrlPGPXRbxRC1hnExA_egrXstXyKcZ_OT5U99Ck&client=633a3230-f761-46b1-ab97-c2d79650636c&height=300&mode=fit","bannerMediaApiFileId":"94ae2c2d-c05c-4595-a455-aa8cd622181e","useDefaultBanner":false,"isBannerAvailable":true,"hasTopBarBeenSplit":false},"portal":{"id":"8","key":"act","projectId":12169,"serviceDeskId":8,"name":"Access & Compliance Team (ACT)","description":"<p>Write to us if you have questions or concerns about data access. Please report potential data violations &amp;/or security incidents to <a href=\"https://sagebionetworks.jira.com/servicedesk/customer/portal/20/group/30/create/194\" class=\"external-link\" rel=\"nofollow noreferrer\" target=\"_blank\">https://sagebionetworks.jira.com/servicedesk/customer/portal/20/group/30/create/194</a>.</p>","portalBaseUrl":"/servicedesk/customer/portal/8","reqTypes":[{"id":"143","name":"Anonymous Access Data ","descriptionHtml":"","callToAction":"Anonymous Access Data ","introHtml":"<p>Click here to explore whether Synapse can support making your data publicly available (i.e., anonymous access)</p>","icon":12637,"iconUrl":"https://sagebionetworks.jira.com/rest/servicedeskapi/requesttype/icon/type/SD_REQTYPE/id/12637","groups":[15],"key":""},{"id":"134","name":"Condition for Use","descriptionHtml":"","callToAction":"Condition for Use","introHtml":"<p>Click here to add a Condition for Use (or Data Access Restriction) to your data</p>","icon":12733,"iconUrl":"https://sagebionetworks.jira.com/rest/servicedeskapi/requesttype/icon/type/SD_REQTYPE/id/12733","groups":[15],"key":""},{"id":"80","name":"Emailed request","descriptionHtml":"","callToAction":"Emailed request","introHtml":"<p>Request received from your email support channel.</p>","icon":12747,"iconUrl":"https://sagebionetworks.jira.com/rest/servicedeskapi/requesttype/icon/type/SD_REQTYPE/id/12747","groups":[15],"key":""},{"id":"260","name":"GENIE Access Request","descriptionHtml":"","callToAction":"GENIE Access Request","introHtml":"","icon":12645,"iconUrl":"https://sagebionetworks.jira.com/rest/servicedeskapi/requesttype/icon/type/SD_REQTYPE/id/12645","groups":[15],"key":""},{"id":"79","name":"Other questions","descriptionHtml":"","callToAction":"Other questions","introHtml":"<p>Don't see what you're looking for? Select this option and we'll help you out.</p>","icon":12769,"iconUrl":"https://sagebionetworks.jira.com/rest/servicedeskapi/requesttype/icon/type/SD_REQTYPE/id/12769","groups":[15],"key":""},{"id":"76","name":"Technical support","descriptionHtml":"","callToAction":"Technical support","introHtml":"<p>Need help installing, configuring, or troubleshooting? Select this to request assistance.</p>","icon":12740,"iconUrl":"https://sagebionetworks.jira.com/rest/servicedeskapi/requesttype/icon/type/SD_REQTYPE/id/12740","groups":[15],"key":""},{"id":"163","name":"ELITE Data Access Requests","descriptionHtml":"","callToAction":"ELITE Data Access Requests","introHtml":"","icon":12602,"iconUrl":"https://sagebionetworks.jira.com/rest/servicedeskapi/requesttype/icon/type/SD_REQTYPE/id/12602","groups":[],"key":""},{"id":"77","name":"Licensing and billing questions","descriptionHtml":"","callToAction":"Licensing and billing questions","introHtml":"<p>Choose this if you have questions about licensing or billing.</p>","icon":12756,"iconUrl":"https://sagebionetworks.jira.com/rest/servicedeskapi/requesttype/icon/type/SD_REQTYPE/id/12756","groups":[],"key":""},{"id":"78","name":"Product trial questions","descriptionHtml":"","callToAction":"Product trial questions","introHtml":"<p>Trying out our product and want more information? Select this and we'll be happy to answer your questions.</p>","icon":12761,"iconUrl":"https://sagebionetworks.jira.com/rest/servicedeskapi/requesttype/icon/type/SD_REQTYPE/id/12761","groups":[],"key":""}],"reqGroups":[{"id":15,"name":"General"}],"orderMapping":{"15":[260,76,79,80,143,134]},"kbs":{"kbEnabled":true,"kbLink":{"appLinkId":"a3b8e349-e434-3cd6-99b4-fcec3e545028","appLinkName":"System Confluence","appLinkUrl":"https://sagebionetworks.jira.com/wiki","spaceKey":"ACT","spaceName":"Access & Compliance Team","spaceUrl":"https://sagebionetworks.jira.com/wiki/spaces/ACT","isServer":false},"labels":[],"projectKey":"ACT","serviceDeskId":8,"kbLinkDomainURLs":["https://sagebionetworks.jira.com"]},"createPermission":true,"portalAnnouncement":{"portalId":8,"canEditAnnouncement":false,"canAdministerProject":false,"portalProjectKey":"ACT","userLanguageHeader":"","userLanguageMessageWiki":"","defaultLanguageHeader":"","defaultLanguageMessage":"","defaultLanguageDisplayName":"English (United States)","isUsingLanguageSupport":false,"translations":{}},"canViewCreateRequestForm":true,"isProjectSimplified":false,"mediaApiUploadInformation":{"token":"eyJhbGciOiJIUzI1NiJ9.eyJpc3MiOiI2MzNhMzIzMC1mNzYxLTQ2YjEtYWI5Ny1jMmQ3OTY1MDYzNmMiLCJhY2Nlc3MiOnsidXJuOmZpbGVzdG9yZTpjb2xsZWN0aW9uOnVwbG9hZC1wcm9qZWN0LTEyMTY5IjpbInJlYWQiLCJjcmVhdGUiLCJ1cGRhdGUiXSwidXJuOmZpbGVzdG9yZTp1cGxvYWQ6KiI6WyJyZWFkIiwiY3JlYXRlIiwidXBkYXRlIl0sInVybjpmaWxlc3RvcmU6Y2h1bms6KiI6WyJyZWFkIiwiY3JlYXRlIl19LCJleHAiOjE3NTM1OTA2NzYsIm5iZiI6MTc1MzU4OTQ3Nn0.q8zcknPrbTPPnUvIzhHekN4VeY8Yb0zxclN3ODW5ELY","targetCollection":"upload-project-12169","endpointUrl":"https://api.media.atlassian.com","clientId":"633a3230-f761-46b1-ab97-c2d79650636c","tokenDurationInMins":20},"categories":{"categoriesSupported":true,"categories":[]}},"reqCreate":{"id":260,"projectId":12169,"issueType":{"id":"10184","name":"GENIE Data Access Requests"},"form":{"name":"GENIE Access Request","descriptionHtml":"","callToAction":"GENIE Access Request","intro":"","instructions":"","icon":12645,"iconUrl":"https://sagebionetworks.jira.com/rest/servicedeskapi/requesttype/icon/type/SD_REQTYPE/id/12645","key":""},"fields":[{"fieldType":"text","fieldId":"email","fieldConfigId":"","label":"Email confirmation to","description":"","descriptionHtml":"","required":true,"displayed":true,"presetValues":[]},{"fieldType":"text","jiraFieldType":"summary","fieldId":"summary","fieldConfigId":"","label":"Summary","description":"","descriptionHtml":"","required":true,"displayed":false,"presetValues":["GENIE Access Request"]}],"userOrganisations":[],"canBrowseUsers":false,"requestCreateBaseUrl":"/servicedesk/customer/portal/8/create/260","requestValidateBaseUrl":"/servicedesk/customer/portal/8/validate/260","calendarParams":{"firstDay":0,"date":"2025-07-26T21:11:17-0700","useISO8601WeekNumbers":false,"dateIfFormat":"%e/%b/%y","dateTimeIfFormat":"%e/%b/%y %I:%M %p","timeFormat":"12"},"kbs":{"kbEnabled":true,"kbLink":{"appLinkId":"a3b8e349-e434-3cd6-99b4-fcec3e545028","appLinkName":"System Confluence","appLinkUrl":"https://sagebionetworks.jira.com/wiki","spaceKey":"ACT","spaceName":"Access & Compliance Team","spaceUrl":"https://sagebionetworks.jira.com/wiki/spaces/ACT","isServer":false},"labels":[],"projectKey":"ACT","serviceDeskId":8,"kbLinkDomainURLs":["https://sagebionetworks.jira.com"]},"canRaiseOnBehalf":false,"canSignupCustomers":false,"canCreateAttachments":true,"attachmentRequiredField":false,"hasGroups":true,"canSubmitWithEmailAddress":false,"showRecaptcha":true,"siteKey":"6LePXLkdAAAAAF4gCNalrL1IvZcqbNbZf_Zakudd","mediaApiUploadInformation":{"token":"eyJhbGciOiJIUzI1NiJ9.eyJpc3MiOiI2MzNhMzIzMC1mNzYxLTQ2YjEtYWI5Ny1jMmQ3OTY1MDYzNmMiLCJhY2Nlc3MiOnsidXJuOmZpbGVzdG9yZTpjb2xsZWN0aW9uOnVwbG9hZC1wcm9qZWN0LTEyMTY5IjpbInJlYWQiLCJjcmVhdGUiLCJ1cGRhdGUiXSwidXJuOmZpbGVzdG9yZTp1cGxvYWQ6KiI6WyJyZWFkIiwiY3JlYXRlIiwidXBkYXRlIl0sInVybjpmaWxlc3RvcmU6Y2h1bms6KiI6WyJyZWFkIiwiY3JlYXRlIl19LCJleHAiOjE3NTM1OTA2NzcsIm5iZiI6MTc1MzU4OTQ3N30.5bb5i-s_RIx0Z9c-wNn7HsgvGKMcpO49NQAfqTk7tec","targetCollection":"upload-project-12169","endpointUrl":"https://api.media.atlassian.com","clientId":"633a3230-f761-46b1-ab97-c2d79650636c","tokenDurationInMins":20},"hasProformaForm":true,"proformaTemplateForm":{"id":784655406527257,"updated":"2025-04-18T18:58:36.157686205Z","publish":{"jira":{"submitOnCreate":true,"validateOnCreate":true},"portal":{"portalRequestTypeIds":[260],"submitOnCreate":true,"validateOnCreate":true}},"design":{"settings":{"templateId":784655406527257,"name":"GENIE Access Request","submit":{"lock":false,"pdf":false},"templateFormUuid":"720f9414-0995-4bdd-bdfb-0fba6613700d"},"layout":[{"version":1,"type":"doc","content":[{"type":"paragraph","attrs":{"localId":"6a3470b3-4c15-43d9-8215-6a809128d6d6"},"content":[{"type":"text","text":"As a condition of receiving access to the AACR Project GENIE database, you must first provide the following information:"}]},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":1},"layout":"default","localId":"0254492b-aaa9-49b4-9cae-4d970d4fc40c"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":2},"layout":"default","localId":"ef645dda-c88e-48e2-96c8-b047c0755868"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":3},"layout":"default","localId":"9a02492c-f585-467e-ac31-fa04ed097eca"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":19},"layout":"default","localId":"8295a28b-69c7-4be3-84e6-c24465a60441"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":20},"layout":"default","localId":"6f04d66c-b763-4291-b47b-110651624380"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":21},"layout":"default","localId":"7d71a8f8-21d4-4e1f-8968-f953bd863bd4"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":4},"layout":"default","localId":"ab5e75d0-1515-4be3-b96f-7a2de30d180e"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":5},"layout":"default","localId":"13584d59-c689-487a-ac2b-5b0936ea40db"}},{"type":"paragraph","attrs":{"localId":"aebdbf4a-3590-4404-86ba-49fa2017fe22"},"content":[{"type":"text","text":"In addition to providing the information requested above, you must certify whether you agree or disagree with the following statements.  By clicking “agree” to any statement, you are certifying that the entire statement is true and correct, subject to any applicable penalties of perjury under the laws of the United States or otherwise."}]},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":10},"layout":"default","localId":"6f391933-17d6-4de5-a527-1fa92adfd445"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":11},"layout":"default","localId":"62ddcdd9-be10-4139-b34c-660ce396879f"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":12},"layout":"default","localId":"8d5c6b59-eb60-462d-a44a-9f9d33685c85"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":13},"layout":"default","localId":"1b8e97b1-ffa5-4c94-947d-424aa07c1a44"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":14},"layout":"default","localId":"7aea2a59-12ce-49b8-81fd-c55a6feff526"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":15},"layout":"default","localId":"932ae0f5-e3f0-436b-ba6c-05f6919ac56a"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":16},"layout":"default","localId":"17d4110f-113d-45d6-9584-bb3e3f28f0ee"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":17},"layout":"default","localId":"ed919f9e-8f5f-4cb4-90e6-4fec52e3a079"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":18},"layout":"default","localId":"1605d0a4-c96f-48f7-9de4-c77c9a97c30c"}},{"type":"paragraph","attrs":{"localId":"1dacd7a4-eb81-4994-9f1a-1e54a32dd45e"},"content":[{"type":"text","text":"Thank you for your submission. Please be aware that you must complete "},{"type":"text","text":"both","marks":[{"type":"strong"}]},{"type":"text","text":" the Synapse request form and this form to gain access to the data. You will receive an email confirmation once your request has been approved."}]},{"type":"paragraph","content":[]},{"type":"paragraph","attrs":{"localId":"4471ffec-a645-4ace-aa7e-b253ff0b5d26"},"content":[{"type":"text","text":"Please send any questions about this form to "},{"type":"text","text":"info@aacrgenie.org","marks":[{"type":"link","attrs":{"href":"mailto:info@aacrgenie.org"}}]},{"type":"text","text":"."}]}]}],"conditions":{},"sections":{},"questions":{"12":{"type":"cd","label":"I declare that I am not employed by, contracted by, or a representative or agent of an entity that has a principal place of business in, or is organized or chartered under the laws of China (including Hong Kong and Macau), Cuba, Iran, North Korea, Russia, or Venezuela.","description":"","validation":{"rq":true},"choices":[{"id":"1","label":"Agree","other":false},{"id":"2","label":"Disagree","other":false}],"questionKey":""},"19":{"type":"tl","label":"Country of residence","description":"","validation":{"rq":true},"choices":[],"questionKey":""},"4":{"type":"tl","label":"Name of employer, client, or entity that you represent","description":"","validation":{"rq":true},"choices":[],"questionKey":""},"13":{"type":"cd","label":"I declare that I am not employed by, contracted by, or a representative or agent of an entity that is 50% or more owned, directly or indirectly, individually or in the aggregate, by one or more of the governments of China (including Hong Kong and Macau), Cuba, Iran, North Korea, Russia, or Venezuela.","description":"","validation":{"rq":true},"choices":[{"id":"1","label":"Agree","other":false},{"id":"2","label":"Disagree","other":false}],"questionKey":""},"16":{"type":"cd","label":"I will not attempt to identify or contact individual participants whose data are included in the dataset, by any means.","description":"","validation":{"rq":true},"choices":[{"id":"1","label":"Agree","other":false},{"id":"2","label":"Disagree","other":false}],"questionKey":""},"5":{"type":"tl","label":"Country of employer, client, or entity that you represent","description":"","validation":{"rq":true},"choices":[],"questionKey":""},"10":{"type":"cd","label":"I declare that I have not been designated a “Covered Person” by the U.S. Attorney General pursuant to 28 CFR 202.211(a)(5) and/or 202.701. ","description":"Additional information available at http://www.justice.gov/nsd","validation":{"rq":true},"choices":[{"id":"1","label":"Agree","other":false},{"id":"2","label":"Disagree","other":false}],"questionKey":""},"21":{"type":"tl","label":"Country where currently located","description":"","validation":{"rq":true},"choices":[],"questionKey":""},"1":{"type":"tl","label":"Full Name","description":"Please provide your first and last name ","validation":{"rq":true},"choices":[],"questionKey":""},"20":{"type":"tl","label":"Country of citizenship","description":"","validation":{"rq":true},"choices":[],"questionKey":""},"2":{"type":"tl","label":"Email address","description":"","validation":{"rq":true},"choices":[],"questionKey":""},"18":{"type":"cd","label":"When publishing or presenting work based on or referencing the AACR Project GENIE data, I will: 1) Cite the following publication: AACR Project GENIE Consortium. AACR Project GENIE: Powering Precision Medicine Through an International Consortium, Cancer Discov. 2017 Aug;7(8):818-831. (include the version of the dataset used in your work.); 2) Include the following acknowledgement: \"The authors would like to acknowledge the American Association for Cancer Research and its financial and material support in the development of the AACR Project GENIE registry, as well as members of the consortium for their commitment to data sharing. Interpretations are the responsibility of the study authors.”; 3) Include the AACR Project GENIE logo on all posters and presentations.","description":"","validation":{"rq":true},"choices":[{"id":"1","label":"Agree","other":false},{"id":"2","label":"Disagree","other":false}],"questionKey":""},"3":{"type":"tl","label":"Synapse username","description":"","validation":{"rq":true},"choices":[],"questionKey":""},"15":{"type":"cd","label":"I declare that if any of these attestations become untrue, I will immediately cease access to any GENIE data and immediately contact AACR to provide notice of any change. ","description":"","validation":{"rq":true},"choices":[{"id":"1","label":"Agree","other":false},{"id":"2","label":"Disagree","other":false}],"questionKey":""},"11":{"type":"cd","label":"I declare that I am not a “foreign person” who is a resident within the territorial jurisdiction of China (including Hong Kong and Macau), Cuba, Iran, North Korea, Russia, or Venezuela. A “foreign person” is anyone who is not a citizen, national, or lawful permanent resident of the United States; admitted to the United States as a refugee under 8 U.S.C. 1157; granted asylum in the United States under 8 U.S.C. 1158; or physically located in the United States.","description":"","validation":{"rq":true},"choices":[{"id":"1","label":"Agree","other":false},{"id":"2","label":"Disagree","other":false}],"questionKey":""},"17":{"type":"cd","label":"I will not redistribute the data, in whole or in part, without express written permission from the AACR Project GENIE Coordinating Center.","description":"For written permission, email genieinfo@aacr.org","validation":{"rq":true},"choices":[{"id":"1","label":"Agree","other":false},{"id":"2","label":"Disagree","other":false}],"questionKey":""},"14":{"type":"cd","label":"I declare that I am not employed by, contracted by, or a representative or agent of an entity that is 50% or more owned, directly or indirectly, individually or in the aggregate, by any of the following: 1) “Covered Person,” as designated by the U.S. Attorney General pursuant to 28 CFR 202.211(a)(5) and/or 202.701; 2) “foreign person” who is a resident of China (including Hong Kong and Macau), Cuba, Iran, North Korea, Russia, or Venezuela [A “foreign person” is anyone who is not a citizen, national, or lawful permanent resident of the United States; admitted to the United States as a refugee under 8 U.S.C. 1157; granted asylum in the United States under 8 U.S.C. 1158; or physically located in the United States]; 3) an entity that has a principal place of business in, is organized or chartered under the laws of China (including Hong Kong and Macau), Cuba, Iran, North Korea, Russia, or Venezuela; or 4) an entity that is 50% or more owned, directly or indirectly, individually or in the aggregate, by one or more of the governments of China (including Hong Kong and Macau), Cuba, Iran, North Korea, Russia, or Venezuela. ","description":"","validation":{"rq":true},"choices":[{"id":"1","label":"Agree","other":false},{"id":"2","label":"Disagree","other":false}],"questionKey":""}}},"uuid":"720f9414-0995-4bdd-bdfb-0fba6613700d"},"proforma":{"formExists":true,"formValid":true,"formTemplateData":{"id":784655406527257,"updated":"2025-04-18T18:58:36.157686205Z","publish":{"jira":{"submitOnCreate":true,"validateOnCreate":true},"portal":{"portalRequestTypeIds":[260],"submitOnCreate":true,"validateOnCreate":true}},"design":{"settings":{"templateId":784655406527257,"name":"GENIE Access Request","submit":{"lock":false,"pdf":false},"templateFormUuid":"720f9414-0995-4bdd-bdfb-0fba6613700d"},"layout":[{"version":1,"type":"doc","content":[{"type":"paragraph","attrs":{"localId":"6a3470b3-4c15-43d9-8215-6a809128d6d6"},"content":[{"type":"text","text":"As a condition of receiving access to the AACR Project GENIE database, you must first provide the following information:"}]},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":1},"layout":"default","localId":"0254492b-aaa9-49b4-9cae-4d970d4fc40c"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":2},"layout":"default","localId":"ef645dda-c88e-48e2-96c8-b047c0755868"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":3},"layout":"default","localId":"9a02492c-f585-467e-ac31-fa04ed097eca"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":19},"layout":"default","localId":"8295a28b-69c7-4be3-84e6-c24465a60441"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":20},"layout":"default","localId":"6f04d66c-b763-4291-b47b-110651624380"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":21},"layout":"default","localId":"7d71a8f8-21d4-4e1f-8968-f953bd863bd4"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":4},"layout":"default","localId":"ab5e75d0-1515-4be3-b96f-7a2de30d180e"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":5},"layout":"default","localId":"13584d59-c689-487a-ac2b-5b0936ea40db"}},{"type":"paragraph","attrs":{"localId":"aebdbf4a-3590-4404-86ba-49fa2017fe22"},"content":[{"type":"text","text":"In addition to providing the information requested above, you must certify whether you agree or disagree with the following statements.  By clicking “agree” to any statement, you are certifying that the entire statement is true and correct, subject to any applicable penalties of perjury under the laws of the United States or otherwise."}]},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":10},"layout":"default","localId":"6f391933-17d6-4de5-a527-1fa92adfd445"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":11},"layout":"default","localId":"62ddcdd9-be10-4139-b34c-660ce396879f"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":12},"layout":"default","localId":"8d5c6b59-eb60-462d-a44a-9f9d33685c85"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":13},"layout":"default","localId":"1b8e97b1-ffa5-4c94-947d-424aa07c1a44"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":14},"layout":"default","localId":"7aea2a59-12ce-49b8-81fd-c55a6feff526"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":15},"layout":"default","localId":"932ae0f5-e3f0-436b-ba6c-05f6919ac56a"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":16},"layout":"default","localId":"17d4110f-113d-45d6-9584-bb3e3f28f0ee"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":17},"layout":"default","localId":"ed919f9e-8f5f-4cb4-90e6-4fec52e3a079"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":18},"layout":"default","localId":"1605d0a4-c96f-48f7-9de4-c77c9a97c30c"}},{"type":"paragraph","attrs":{"localId":"1dacd7a4-eb81-4994-9f1a-1e54a32dd45e"},"content":[{"type":"text","text":"Thank you for your submission. Please be aware that you must complete "},{"type":"text","text":"both","marks":[{"type":"strong"}]},{"type":"text","text":" the Synapse request form and this form to gain access to the data. You will receive an email confirmation once your request has been approved."}]},{"type":"paragraph","content":[]},{"type":"paragraph","attrs":{"localId":"4471ffec-a645-4ace-aa7e-b253ff0b5d26"},"content":[{"type":"text","text":"Please send any questions about this form to "},{"type":"text","text":"info@aacrgenie.org","marks":[{"type":"link","attrs":{"href":"mailto:info@aacrgenie.org"}}]},{"type":"text","text":"."}]}]}],"conditions":{},"sections":{},"questions":{"12":{"type":"cd","label":"I declare that I am not employed by, contracted by, or a representative or agent of an entity that has a principal place of business in, or is organized or chartered under the laws of China (including Hong Kong and Macau), Cuba, Iran, North Korea, Russia, or Venezuela.","description":"","validation":{"rq":true},"choices":[{"id":"1","label":"Agree","other":false},{"id":"2","label":"Disagree","other":false}],"questionKey":""},"19":{"type":"tl","label":"Country of residence","description":"","validation":{"rq":true},"choices":[],"questionKey":""},"4":{"type":"tl","label":"Name of employer, client, or entity that you represent","description":"","validation":{"rq":true},"choices":[],"questionKey":""},"13":{"type":"cd","label":"I declare that I am not employed by, contracted by, or a representative or agent of an entity that is 50% or more owned, directly or indirectly, individually or in the aggregate, by one or more of the governments of China (including Hong Kong and Macau), Cuba, Iran, North Korea, Russia, or Venezuela.","description":"","validation":{"rq":true},"choices":[{"id":"1","label":"Agree","other":false},{"id":"2","label":"Disagree","other":false}],"questionKey":""},"16":{"type":"cd","label":"I will not attempt to identify or contact individual participants whose data are included in the dataset, by any means.","description":"","validation":{"rq":true},"choices":[{"id":"1","label":"Agree","other":false},{"id":"2","label":"Disagree","other":false}],"questionKey":""},"5":{"type":"tl","label":"Country of employer, client, or entity that you represent","description":"","validation":{"rq":true},"choices":[],"questionKey":""},"10":{"type":"cd","label":"I declare that I have not been designated a “Covered Person” by the U.S. Attorney General pursuant to 28 CFR 202.211(a)(5) and/or 202.701. ","description":"Additional information available at http://www.justice.gov/nsd","validation":{"rq":true},"choices":[{"id":"1","label":"Agree","other":false},{"id":"2","label":"Disagree","other":false}],"questionKey":""},"21":{"type":"tl","label":"Country where currently located","description":"","validation":{"rq":true},"choices":[],"questionKey":""},"1":{"type":"tl","label":"Full Name","description":"Please provide your first and last name ","validation":{"rq":true},"choices":[],"questionKey":""},"20":{"type":"tl","label":"Country of citizenship","description":"","validation":{"rq":true},"choices":[],"questionKey":""},"2":{"type":"tl","label":"Email address","description":"","validation":{"rq":true},"choices":[],"questionKey":""},"18":{"type":"cd","label":"When publishing or presenting work based on or referencing the AACR Project GENIE data, I will: 1) Cite the following publication: AACR Project GENIE Consortium. AACR Project GENIE: Powering Precision Medicine Through an International Consortium, Cancer Discov. 2017 Aug;7(8):818-831. (include the version of the dataset used in your work.); 2) Include the following acknowledgement: \"The authors would like to acknowledge the American Association for Cancer Research and its financial and material support in the development of the AACR Project GENIE registry, as well as members of the consortium for their commitment to data sharing. Interpretations are the responsibility of the study authors.”; 3) Include the AACR Project GENIE logo on all posters and presentations.","description":"","validation":{"rq":true},"choices":[{"id":"1","label":"Agree","other":false},{"id":"2","label":"Disagree","other":false}],"questionKey":""},"3":{"type":"tl","label":"Synapse username","description":"","validation":{"rq":true},"choices":[],"questionKey":""},"15":{"type":"cd","label":"I declare that if any of these attestations become untrue, I will immediately cease access to any GENIE data and immediately contact AACR to provide notice of any change. ","description":"","validation":{"rq":true},"choices":[{"id":"1","label":"Agree","other":false},{"id":"2","label":"Disagree","other":false}],"questionKey":""},"11":{"type":"cd","label":"I declare that I am not a “foreign person” who is a resident within the territorial jurisdiction of China (including Hong Kong and Macau), Cuba, Iran, North Korea, Russia, or Venezuela. A “foreign person” is anyone who is not a citizen, national, or lawful permanent resident of the United States; admitted to the United States as a refugee under 8 U.S.C. 1157; granted asylum in the United States under 8 U.S.C. 1158; or physically located in the United States.","description":"","validation":{"rq":true},"choices":[{"id":"1","label":"Agree","other":false},{"id":"2","label":"Disagree","other":false}],"questionKey":""},"17":{"type":"cd","label":"I will not redistribute the data, in whole or in part, without express written permission from the AACR Project GENIE Coordinating Center.","description":"For written permission, email genieinfo@aacr.org","validation":{"rq":true},"choices":[{"id":"1","label":"Agree","other":false},{"id":"2","label":"Disagree","other":false}],"questionKey":""},"14":{"type":"cd","label":"I declare that I am not employed by, contracted by, or a representative or agent of an entity that is 50% or more owned, directly or indirectly, individually or in the aggregate, by any of the following: 1) “Covered Person,” as designated by the U.S. Attorney General pursuant to 28 CFR 202.211(a)(5) and/or 202.701; 2) “foreign person” who is a resident of China (including Hong Kong and Macau), Cuba, Iran, North Korea, Russia, or Venezuela [A “foreign person” is anyone who is not a citizen, national, or lawful permanent resident of the United States; admitted to the United States as a refugee under 8 U.S.C. 1157; granted asylum in the United States under 8 U.S.C. 1158; or physically located in the United States]; 3) an entity that has a principal place of business in, is organized or chartered under the laws of China (including Hong Kong and Macau), Cuba, Iran, North Korea, Russia, or Venezuela; or 4) an entity that is 50% or more owned, directly or indirectly, individually or in the aggregate, by one or more of the governments of China (including Hong Kong and Macau), Cuba, Iran, North Korea, Russia, or Venezuela. ","description":"","validation":{"rq":true},"choices":[{"id":"1","label":"Agree","other":false},{"id":"2","label":"Disagree","other":false}],"questionKey":""}}},"uuid":"720f9414-0995-4bdd-bdfb-0fba6613700d"},"linkedJiraFields":[]},"key":""},"portalWebFragments":{"headerPanels":[],"subheaderPanels":[],"footerPanels":[],"pagePanels":{"propertyPanels":[],"legacyPropertyPanels":[]}}}
{"headless":false,"tourEnabled":false,"wacLink":"https://www.atlassian.com/software/jira/service-desk/powered-by?utm_medium=jira-in-product&utm_source=jira_service_desk_portal_footer&utm_content=sagebionetworks","serviceDeskVersion":"3.3.0-OD","contextPath":"","xsrfToken":"36a11afbb0d71e400533fb32a719fc63baaa45a4_lout","baseUrl":"https://sagebionetworks.jira.com/servicedesk/customer","relativeBaseUrl":"/servicedesk/customer","jiraDisplayUrl":"https://sagebionetworks.jira.com","customerLoginEnabled":true,"maxAttachmentSize":"31457280","gravatarEnabled":false,"onDemand":true,"disabledFeatures":[],"enabledDarkFeatures":[],"calendarDateData":{"months":["January","February","March","April","May","June","July","August","September","October","November","December"],"monthsShort":["Jan","Feb","Mar","Apr","May","Jun","Jul","Aug","Sep","Oct","Nov","Dec"],"weekdaysShort":["Sun","Mon","Tue","Wed","Thu","Fri","Sat"],"weekdays":["Sunday","Monday","Tuesday","Wednesday","Thursday","Friday","Saturday"]},"mediaApiExternalUrl":"https://api.media.atlassian.com","mediaApiAppClientId":"633a3230-f761-46b1-ab97-c2d79650636c","optedInFeatures":{},"fabricEmojiUrl":"/gateway/api","helpCenterType":"BASIC","traceId":"d3d5ee14a57c469cbccff2cf0cb60a24","siteDefaultLanguageTag":"en-US","featuredValues":{"multiHelpCenterEnabled":false,"hcAIAnswersEnabled":false,"jsmAiConfigEnabled":false,"helpCenterCustomizationEnabled":false},"helpCenterHomePageSlug":"portals","anonymousEnabled":true,"requestIntroEnabled":true}