These forms are for network participants to submit requests for the ICN Outcomes Registry. Click on the buttons below to download the forms as a Word document to fill out and submit back to [email protected].
If you have a request for a data query using Outcomes Registry data from ICN, including research data for your study, please fill out the form and submit it to [email protected]
If you have a request for a new measure or additional data elements to be added to the ICN Outcomes Registry, please fill out the form and submit it to [email protected]
If you have a request for an enhancement, modification, or other alteration to data collected and/or shared in the ICN Outcomes Registry, please fill out the form and submit it to [email protected]
If you would prefer, you can submit your request electronically.