LHB Site On-Boarding Registration

Welcome to the Privacy Preserving Record Linkage (PPRL) hashing community.

Purpose of this form: Register your site with Regenstrief Institute's Linkage Honest Broker Service, allowing secure submission of encrypted tokens.

What you will need to complete the form:

Investigator's Name
Public Static IP or CIDR Block
Individual's contact information who requires a Secure File Transfer Protocol (SFTP) account with the LHB. These individuals are responsible for submitting the encrypted token payloads to the LHB.

Has the Linkage Honest Broker (LHB) Agreement been signed?

* must provide value

Yes

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Please check with your governance team for status of LHB Agreement.

It is required that the LHB Agreement must be signed prior to on-boarding with the Linkage Honest Broker.

Once the LHB Agreement is signed, please return to this form to complete the registration/on-boarding process.

Thank you.
The Linkage Honest Broker Team

Formal Site Name

* must provide value

If you did not find your Site Name in the list, please type the full name here

Principal Investigator's Name

* must provide value

Please click a button to confirm that you are either the Principal Investigator or formal designee

* must provide value

I verify that I am indeed the Principal Investigator of this Research project

I verify that I am the designated proxy for the Principal Investigator to complete this form on their behalf

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Your Name

* must provide value

Your E-mail address

* must provide value

Please provide your Public Static IP or CIDR block

SFTP Server Network Connectivity Allow list:

Public Static IP or CIDR block:

Public Static IP or CIDR block:

Please provide the following information for users that need an SFTP

User Required Information

User's First Name	User's Last Name	User's Email

Primary Technical Contact Information

Primary Technical Contact Name

* must provide value

E-mail address

* must provide value

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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.