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The form templates are available here so that the requestor may become familiar with the information which will be requested on web request forms. The templates are not editable and cannot be used to submit a request. You may submit a request from our list of Currently Available Collections.

Request Data Only (Readonly)

If you are interested in requesting specific collection data from NIA, update and submit the form below and a member of the AgingResearchBiobank staff will contact you within 7-10 days. If desired, you may save the form instead and return to complete it at a later time. For further details regarding the request workflow, please refer to the User's Guide (PDF - 1,678 KB).

You will need to complete the required fields below and provide the following documentation before your request is reviewed by the Biobank Scientific Review Committee (BSRC):

  1. Protocol (See Glossary for more information)
  2. IRB Approval (or waiver)
  3. CV

The BSRC will review requests three times a year in the months of January, May, and September. The BSRC will only review a request that has submitted all of the required documentation, noted above. The documents submitted will be examined to ensure they comply with NIA requirements prior to the BSRC's review. If documents are missing your submitted request will not be reviewed by the BSRC until the documentation is complete or until the next BSRC meeting period. The online application as well as all required documentation must be submitted prior to the following dates to be included in the BSRC review period:

  1. BSRC Review Period 1 (2024) Deadline: January 15th, 2024
  2. BSRC Review Period 2 (2024) Deadline: May 15th, 2024
  3. BSRC Review Period 3 (2024) Deadline: September 15th, 2024

If your request is approved, the Outgoing Human Resources Transfer Agreement (OHRTA) will need to be signed by the PI and the institution's signing official.

All fields are required.

Request Identifier
Full title for the proposed research
Requestor Information

Brief summary (1-2 sentences) of the proposed research to be made public if the request is approved. A more detailed summary and protocol are also required separately in the Request Details section below. (Limit 500 characters)

Principal Investigator Information
The Principal Investigator (PI) must have the level of authority and oversight responsibility to fulfill the OHRTA/OHDTA requirements for that role. Students and temporary staff are not eligible to sign the OHRTA/OHDTA as the PI. Please designate a faculty advisor or supervisor as the study PI, and include the names and titles of the student or temporary staff among the Other Authorized Users.
Authorized Users
Signing Official Information
A Signing Official (SO) from your institution will be asked to provide their signature in the transfer agreement. An SO has institutional authority to legally bind the institution in grants administration matters. The individual fulfilling this role may have any number of titles in the grantee organization. For most institutions, the SO is located in its Office of Sponsored Research or equivalent.
Support Information
Institution Type
Number of years in scientific research
Approximately how many years has the lead investigator been involved in scientific research?
Is funding currently available for this research?
If funding is not yet available, please indicate anticipated primary funding source.
If funding is non-NIH, please attach supporting documentation below.
Request Details
Please select the studies you would like to request. If requesting SWAN, that is the only study you may request.
Have you previously acquired data, images, or biospecimens from the study collection(s) being requested?
Does your proposal require linking biobank materials to the existing data, images, or biospecimens described above?
A brief overview of your research needs. This is in addition to the full protocol to be attached below.
Include the participants inclusion/exclusion criteria, study visit periods, key analytic variables, primary and secondary outcome measures, follow-up period if applicable, and planned statistical methods. Inadequately described request may be deferred until a complete/ satisfactory description is provided.
Will the results be used for a commercial purpose?
A "Yes" response defines this as a "Commercial Purpose" request.
Information Security: Please check the information security practices to be used
Study data must be maintained in a secure and controlled environment
e.g. Amazon Web Services, Microsoft Azure, Google Cloud Platform / what tools will be used and how these tools relate to the project