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Data request form

All applications for data must be approved by the regional governance group and/or Clinical Advisory Group (CAG) of the Breast Cancer Foundation National Register (BCFNR). Your request will be reviewed and you will be notified in due course of the decision. To ensure patients’ privacy and confidentiality is maintained, the Register will only release de-identified data.

Data requests may incur a cost, particularly if the work is complex. We will provide you with an estimate if needed for a funding application, or inform you of the cost before we commence work on your approved data request.
At completion, you are required to provide the BCFNR with a copy of the output generated from the data requested and ensure the BCFNR & its funders are acknowledged.

Please consult with the regional BCFNR Data Manager BEFORE you submit this application to ensure your data requirements can be met by the Registers.

Name of BCFNR Data Manager consulted

Please attach a copy of your project/research brief

Please provide a brief description of your project & its aims below

Please describe whether and how your study may benefit Māori. Please include information specific to Māori (if known) and any useful statistics. If these are not known, please state so.

Please do not cite Te Tiriti o Waitangi / the Treaty of Waitangi as a health benefit. Equal access to participation in clinical research is not a health benefit but rather the default expectation.

Please describe the Māori consultation process for the study.

If not applicable, please state why.

Please upload evidence of Māori consultation, if available.

Please describe whether and how your study may benefit Pacific people. Please include information specific to Pacific people (if known) and any useful statistics.

If these are not known, please state so.

Please describe the Pacific people consultation process for the study.

If not applicable, please state why.

Please upload evidence of Pacific consultation, if available.

E.g. a poster, scientific paper, thesis, presentation, education
publishing
require ethics approval
is research funded
The BCFNR will strive to provide the data in a timely manner however this may depend on the workload.

Please enter the period of data requested.

Use the diagnosis dates.

Diagnoses date starting from:

Diagnoses date ending at:

National or district data requested?

national or regional

If you are a clinician working within Health New Zealand, please provide your locality approval.