Research Reporting Request Form Name* First Last Department* Email* Enter valid UConn/UCH Email Confirm valid UConn/UCH Email HiddenEmailDNU Phone Number*Enter a brief description of the data needed. Please include data elements to include, time frame (e.g. fiscal year), level of detail (e.g. summarized at Department, PI, project or account).*Frequency of report (How often would you like to receive this request?) One-time report Monthly Weekly Other If Other frequency is selected, how often would you like to receive this request? Provide a brief business justification for the data need.*Optional File Attachment Drop files here or Select files Accepted file types: xls, xlsx, pdf, docx, Max. file size: 100 MB, Max. files: 4. Date Report Needed:* MM slash DD slash YYYY Please enter the date report data is expected. We will make every effort to accommodate your request deadline. Non-standard or complex requests may require additional time to complete. CAPTCHANameThis field is for validation purposes and should be left unchanged.