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LSHTM Open Data Kit Device Request Form
This form should be used to request an ODK@LSHTM account
Email address *
Personal Details
Your Name *
Your answer
Faculty (within LSHTM) *
Which Department are you linked to
Your answer
Project Details
Please enter the name of your project
Project Name *
Your answer
Short Name (No punctuation marks or spaces) *
Your answer
Which devices do you need?
Requests for more than ten devices should be emailed directly to odk.lshtm.ac.uk
Android Tablets (8 inch)
Android Phones (6 inch)
10,000 mAh Power pack
20,000 mAh Power pack
3G/4G Wifi Hotspot (Wifi Dongle)
Thermofocus Non Contact Thermometer
Context
Is this project part of a PhD, MSc, Dphil or similar? *
Principal Investigator / Line manager / Project Supervisor
Please give the name and email address of the principal investigator/ project supervisor of the study
ALL Students must enter the name of an LSHTM staff member who is willing to act as PI
Principal Investigator Name *
Your answer
Principal Investigator Email address *
Your answer
Dates
Please enter the expected dates for this project
Start Date *
Your answer
End Date *
Your answer
Non LSHTM applicants
Please enter the name and postal address of your institution
Your answer
Acknowledgement
We request that you acknowledge our support in research papers and reports that come from studies using LSHTM Open Data Kit

If you are happy to do so, please paste this text in to the acknowledgments section of your outputs…

“Electronic data solutions were provided by LSHTM Open Research Kits (odk.lshtm.ac.uk).”
Consent for use of personal data
We need to keep a record of your personal data (Name, email etc) in order to be able to provide our services and to contact you about your project. We may also occasionally wish to contact you to seek your opinions and experiences in surveys, to obtain case studies and as part of our public engagement or dissemination work. We can only do this is you provide explicit consent using the questions below
Consent for data storage *
I consent to my data being stored by the LSHTM Open Research Kits team, LSHTM Information Technology Services and on request by senior management of LSHTM. I understand that no data will be passed on to any third parties without additional consent
Required
Service critical communications, T&Cs *
I consent to being contacted by the LSHTM Open Research team for service critical updates and operational reasons
Required
Surveys and Case Studies *
I consent to being contacted by the LSHTM Open Research team for surveys, case studies, public engagement and other matters that could improve service provision in the future or raise the profile of the project or the school.
Required
Newsletters/ Service Updates *
I consent to being sent occasional email newsletters, service updates and updated terms and conditions.
Required
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