Data Transfer Initiation Form

Please complete this form for all data sets that will be transferred to NB-IRDT. The form can be submitted to the Data Transfer Coordinator via email at nb-irdtdata@unb.ca.

Contact Information
Data Business Owner (DBO) (Individual/Organization) Click or tap here to enter text. DBO Primary Contact Name Click or tap here to enter text. DBO Primary Contact Email Click or tap here to enter text. NB-IRDT/MEKTU primary contact (if applicable) Click or tap here to enter text.
Data Set Details
Data Set Name Click or tap here to enter text. Is there a project number associated with this data set (ex. Clockify)? ☐Yes (Please indicate: Click or tap here to enter text.) ☐No ☐ Other: Click or tap here to enter text. Is there a variable list available for this data set? (If yes, please attach) (Note: Qualitative data/questions are variables). ☐Yes ☐No ☐ In Progress Data Type (Select one): (hover mouse over terms for definitions) ☐Quantitative ☐Qualitative ☐Both Quantitative and Qualitative Data Information Type (Select all that apply): (hover mouse over terms for definitions) ☐ Aggregate/Summary Personal Information Data ☐ Aggregate/Summary Personal Health Information Data ☐ Line Level Personal Data ☐ Line Level Personal Health Data (e.g., qualitative data) ☐ Non-personal data (e.g., environmental information) ☐ Other
Data Sharing Details
Data transfer: How will the data be shared with NB-IRDT? ☐ Electronic transfer on a secure media device (e.g., CVS, flat file, etc.) ☐ Electronic transfer through email (e.g., CVS, flat file, PDFs, Lime survey results) ☐ Paper copies will be shared ☐ Data to be downloaded from the internet (please provide website URL): Click or tap here to enter text. Restriction on Use of Data: Has the Data Business Owner asked for any restrictions on usage or access to the data? (E.g. Is access limited to specific project team members). ☐ Yes If yes, please provide details of the request: Click or tap here to enter text. ☐ No ☐ TBD Active Retention: Where do you anticipate the data will be held during while project is open? (Check all that apply). ☐Project-specific folder in the Secure Research Environment (i.e., the lab) ☐Project-specific secure SharePoint folder ☐Personal laptop/desktop ☐ Other (please specify): Click or tap here to enter text. Inactive Storage & Destruction: Are there any special requirements for the retention and/or destruction of the data at project closure? (E.g. data returned on encrypted device.) ☐Yes If yes, please provide details below: Click or tap here to enter text. ☐No Other considerations: Click or tap here to enter text.