The code block below illustrates how one might use # and // as comments in your logic and calculations.

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This value you provided is not an integer. Please try again.

The value entered is not a valid Vanderbilt Medical Record Number (i.e. 4- to 9-digit number, excluding leading zeros). Please try again.

The value you provided must be within the suggested range

The value you provided is outside the suggested range

This value is admissible, but you may wish to double check it.

The value entered must be a time value in the following format HH:MM within the range 00:00-23:59 (e.g., 04:32 or 23:19).

This field must be a 5 or 9 digit U.S. ZIP Code (like 94043). Please re-enter it now.

This field must be a 10 digit U.S. phone number (like 415 555 1212). Please re-enter it now.

This field must be a valid email address (like joe@user.com). Please re-enter it now.

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Required format:

4xQfHjP4NUAGDNdXnILeKZuR7VS3hynjvbDvhoECmXmWSkcDKTkktH4L9SQP

New eLab Account Request Form

Please complete this form to request a new eLab account. After your request is received, it will be reviewed by the UNMC Research IT Office (RITO), who will reach out regarding your request.

If you have questions about eLab, please contact RITO (rito@unmc.edu).

First Name:		Last Name:
UNMC Email:

Accounts must be assigned to a UNMC email address!
Please enter your UNMC email address.

Primary Role:

* must provide value

Please provide the contact details for your primary Supervisor (If you are PI please add Chair or Dean):

Supervisor Name:

Supervisor Email:

Primary College, Institute, or Unit:

* must provide value

Which Department/Division in
______?

* must provide value

Which Department in College of Medicine?

* must provide value

Which Division of ______?

* must provide value

Other College/Institute/Unit - Please Describe:

* must provide value

Other CoM Department - Please Describe:

* must provide value

Are you part of any VCR core?

* must provide value

Yes

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Are you part of a group license?

* must provide value

Yes

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Which group you belong to?

* must provide value

Please provide the group license administrator Full name :

* must provide value

Please provide the group license administrator email :

* must provide value

Please select your Core (Select all that apply)

* must provide value

Advanced Microscopy Core Facility

Bioinformatics and Systems Biology Core

Flow Cytometry Research Facility

Genomics Core Facility

Multiomics Mass Spectrometry Core Facility (Dr. Gundy already has eLab)

Mouse Genome Core

NMR Core Facility

READI Core

Research IT Office

Animal Behavior Core (already has an elab account)

Electron Microscopy

Nebraska Biobank

BSL-3 Core

Which one is your primary Core from the above list?

* must provide value

Will you be an eLab primary core group admin?

* must provide value

Yes

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Each eLab account will be charged for an annual fee ( $115/user account) for the usage in every fiscal year, Please provide the valid Cost Center Number here ( no dash or space) :
* Please note each eLab account you added later to your group will be billed for this fee as well.

* must provide value

At this time, two of the eLabNext modules are availible at UNMC:

eLab Journal — an all-in-one Electronic Lab Notebook
eLab Inventory — an advanced inventory management system

Which of the following eLab modules do you plan to use in your laboratory?
(select all that apply)

* must provide value

eLab Journal

eLab Inventory

Thank you for completing the form, please click SUBMIT below.

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To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.