CTSU Roster Update Form

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CTSU ROSTER UPDATE FORM
Please note that all persons added to the CTSU site rosters must have an active status with the NCI.
and
on a network roster.
assigned the
CTSU
or Data Administrator
must
hold a registration
type of Associate
Investigators
must Individuals
register annually
with
theAdministrator
Pharmaceutical
Management
Branch
and associates
must Plus
or higher. To register in the Registration and Credential Repository (RCR) go to https://ctepcore.nci.nih.gov/rcr.

maintain an active CTEP-IAM account. To link to the CTEP-IAM go to https:/eapps-ctep.nci.nih.gov/iam.
Network Updates:

Cooperative GroupIndividuals
Updates:
network treatment roster of the institution.
Investigators added to the CTSU institution rosters must be active on a Cooperative Group
treatment roster of the institution.
Roles may be assigned to the person by the Site Administrator or Site Data Administrator via the
https://www.ctsu.org/public/Default.aspx
under the
RUMS tab.
CTSU members’ web site at https://members.ctsu.org
under the Regulatory
tab.
relocated submission instructions here:

a listing
if required)Select the Membership/Supply document type.
Add
orthe
Delete
to site roster:
(attach
Upload
formpersons
to the Regulatory
Submission
Portal
at www.ctsu.org.
Site Name
Institution Code
CTEP Person ID
Person Name
Add
Delete
Person Person
; a person must have the Associate Plus
registration type to hold either of these roles.)

Update or Delete the CTSU Administrator and/or Data Administrator role at an institution: (Only
updated instructions for assigning roles
1 person may hold either the Site Admin or Data Admin role at an institution.)
Site Name
Institution
CTEP
Person Name
Role (Admin Add
Delete Delete
Code
Person
or DA)
Role
Role
Role &
ID
Only
Roster
Record

Person accepting the role of Site Administrator must sign the statement below:
I understand that all general correspondence for CTSU related activities will be directed to my
attention and it is my responsibility to forward such correspondence to the appropriate physician
and staff members at my institution. It is also my responsibility to assign staff roles and to access
restricted areas of the CTSU web site as required.
Signature: ___________________________

Date: _________________

Persons accepting the role of Site Data Administrator must sign the statement below:
I understand that all CTSU general data management correspondence will be directed to my
attention. I may assign data management responsibilities for individual protocols or organizations
to data management staff at my institution, but it is my responsibility to keep the names of these
individuals current via the roster maintenance screens on the CTSU web site.
Signature: __________________________

Date: ___________________

Please return the completed form to the CTSU Membership Coordinator at fax 1-888-691-8039.
Person submitting form:________________________________ CTEP ID_______________
Reversed order of
Date: __________________________
CTEP ID and Date.

Internal Use Only

Date Received

July_2018
Final_October_2016
Authorized by CTSU for local reproduction

Date Processed

Processor

QA