Key
blue text is the type of form field used online, and also says something about the type of db field
Welcome. The Innovation Unit provides a wide variety of resources. (more text here... describe VMs, devices, software, etc.) If need physical collab space...do the following....
If you would you like to have a consultation session with IIU's Innovation team... bla bla bla. Below....
Contact Information
Please list names and email addresses of your team members who will require access to the requested lab resources:
First Name* Last Name* Organization* Phone Email* Primary point of contact? Login needed? Notifications (admin) Username (admin)
(please select at least 1)
text field: single text field: single text field: single text field: single text field: single Checkbox Checkbox radial: default yes (admin) text field: single (admin)
text field: single text field: single text field: single text field: single text field: single Checkbox Checkbox radial: default yes (admin) text field: single (admin)
text field: single text field: single text field: single text field: single text field: single Checkbox Checkbox radial: default yes (admin) text field: single (admin)
Add more button
Group name text field: single (admin)
Project Details
Project Title/Name: text field: single line
Requested Start Date: text field: auto calendar
Requested End Date: text field: auto calendar
You have requested an engagement to last 3 months, 2 weeks and 4 days. (dynamic user notification once start and end dates are entered)
Approved project Start Date: text field: auto calendar (admin) Use same date as Requested checkbox (admin - will auto fill this date with requested date)
Approved project End Date: text field: auto calendar (admin) (10 changes...max)
Project Type: 3-item drop-down list with Choices: Prototype, Evaluation, Hybrid (admin)
Project Use: 3-item drop-down list with Choices: Internal, External, Collaborative (admin)
We can best help you meet your needs if we have a general understanding of your project. Please help us frame your project by addressing the following questions. Even if you are only requesting use of the physical laboratory space, a project summary will allow us to potentially leverage other R&D technology initiatives in working with you.
Project Summary: text box: multi-line
Project Goals: text box: multi-line
Project Success Criteria: text box: multi-line
Project Stakeholders:
Who are the stakeholders (users/actors) in your proposed engagement? Please list key technology users, data suppliers, report recipients, as well as any applicable governing guidelines (e.g., HIPAA).
Stakeholder* Role** #
text field: single text field: single
text field: single text field: single
text field: single text field: single
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*Organization, C/I/O, user group, individual, etc. **e.g., User, data supplier, report recipient, governing body. #Please note that you can choose more than one role per stakeholder.
Technology Requirements
The Lab has defined a set of core technology standards which can be quickly installed as a default (i.e., not otherwise specified). Please modify as needed for your specific project requirements. Please list specific software needed in the Notes section.
Technology Resource Type:
Drop-down list: Virtual Computer (Desktop, server, etc), Physical Hardware (mobile device, etc.), Online tools (wiki, project management, etc.), Other.
(Depending on the above selection, one of the following sections will appear)
Resource Type 1: Virtual Computer (Desktop, server, etc)
VM Configuration: Drop-down select - example: Windows7 desktop, Windows Server 2008, SQL Server, CentOS, Other, etc. (need exact list from Dale)
Notes: text box: multi-line
Do you need this VM to be an externally accessible resource? (e.g., http://yourservername.phiresearchlab.org) radial: yes no
If yes, show Requested subdomain (e.g., yourservername) text field: single, Server Port (e.g, 8080) text field: single External Port (e.g, 80) text field: single
VM name: text field: single line (admin)
Internal Notes: text box: multi-line (admin)
Proxy from: text field: single line (admin)
Proxy to: text field: single line (admin)
Resource start date: text field: auto calendar, default to project start date (admin only)
Resource end date: text field: auto calendar, default to project enddate (admin only)
Resource Type 2: Physical Hardware (mobile device, etc.),
Device: Drop-down select - example: iPhone, Nook, iPad, Other, etc. (need exact list from Tom)
Notes: text box: multi-line
Inventory ID #: text field: single line (admin)
Date Provided: text field: auto calendar (admin)
Project Recipient Name: text field: single line (admin)
Date Returned: text field: auto calendar (admin)
IIU Staff Recipient Name: text field: single line (admin)
Notes: text box: multi-line (admin)
Resource Type 3: Online tools (wiki, project management, etc.)
Tool: Drop-down select - example: Applab, JIRA, Confluence, Github, Other, etc. (need exact list from Tom)
Notes: text box: multi-line
Notes: text box: multi-line (admin)
Resource Type 4: Other
Notes: text box: multi-line
Notes: text box: multi-line (admin)
(After each resource you add, this will show below to add another)
Add another Technology Resource: Drop-down list: same type selection and functionality as above
Will any of your resources connect to any systems/databases outside the IIU laboratory network? Radial buttons: Yes No
*Please note that... blah....
If yes, please provide details: text field: multi-line
Does your project involve the use / testing of data (synthetic data, publicly available, etc.,) Radial buttons: Yes No
If yes, please describe the following:
What is/are the primary sources of data, if any, for the proposed technology? Please note that all data sets must be examined (e.g., for privacy & security) prior to loading into the lab environment. The lab can provide synthetic data if necessary.
text field: multi-line
Will your project require access to any third-party websites and/or applications? Radial buttons: Yes No
If yes, please provide details: text field: multi-line
Please feel free to provide any additional information regarding your technology needs below. text box: multi-line
Project Status: 9-item drop-down list (admin) Choices: On Hold, Awaiting Submission, Under Review, Submitted, Rejected, Submitter Revising, Approved, Discontinued, Completed
Changer: text field: single (admin)
Project Status Notes: text field: multi-line (admin)
Infrastructure Status: 9-item drop-down list (admin) Choices: Ready, To Set Up, On Hold, Setting Up, Modifying, To Take Down, Taking Down, Removed, Archived
Changer: text field: single (admin)
Project Status Notes: text field: multi-line (admin)
Outcome / Summary / General Notes: text box: multi-line {this field is admin only]
Please confirm that all the entered information is accurate. Click "Submit" when ready.
Once you have submitted your information, if you need to make changes, please contact the R&D Lab at informaticslab@cdc.gov
Submit button
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