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Academic Research License

The ACG System continues to evolve through research and development conducted at the Johns Hopkins Bloomberg School of Public Health. If you are currently working for an educational/research organization, or conducting research under the auspices of a research foundation grant, a discounted and temporary ACG System Academic Research License may be available if you meet the following criteria:

Research results will be made public (i.e., disseminated to any interested party, presented at conferences or published in peer reviewed journals)
Research results will not be used to make financial, clinical, or managerial decisions within your own or any other organization
Copies of all research reports and/or articles will be provided to Johns Hopkins

If you meet the above criteria, you may apply for an Academic Research License by submitting the online application below. If your application is approved, you will receive a Licensing Agreement for signature and payment prior to receiving the software and documentation. If you have any questions, please email us.

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Name
First Name*
Last Name*
Title
Email*
Phone Number
Organization Name*
Website
Organization Type
Address
City
State
Zip
Country
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Market Segment
Area of Interest*
Check all that apply:
- Population Health
- Care Management
- Performance Analysis
- Finance/Budget
- Research
- Integration
- Other
Intended Use*
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Owner ID (Alan)
Owner ID (Sarah)
Owner ID (Stuart)
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Academic Research License Application

THIS FORM IS TO BE COMPLETED AND SIGNED BY THE RESEARCH TEAM LEADER.
Please be prepared to sign a paper application, answer additional questions and submit additional documentation if necessary.

Exhibit A
APPLICATION FOR ACG SYSTEM LICENSE
Project Title*
Research Team Leader Name
Salutation
Research Team Leader First Name*
Research Team Leader Last Name*
Research Team Leader Title*
Name of Organization*
Name of Unit*
Organization Type
Street Address*
City
State - OLD
State
Country - OLD
Country
Postal/Zip Code*
Email*
Phone Number*
Fax
Market Segment
Website
Person to whom download information should be sent (if different than above):
Name
Email
If this is for dissertation research, please provide the following information about your advisor:
Advisor Name
Advisor Email
Describe your organization*
Describe how you intend to use the ACG System software*
Objectives of the study*
Dataset to be used in the study, including its source*
Coding systems used*
Size of study population*
What is the timeframe of the captured data?*
What are the anticipated start and completion dates of the study?*
Funding sources for the study*
Describe how the results will be used*
Describe where and how you expect to present your results*
CONFLICT OF INTEREST DISCLAIMER*
IF THIS IS A RENEWAL, please attach copies of all non-confidential final reports or publications you have produced using the ACG System software. If you have not completed any reports or publications, please attach a progress report describing the current status of your research project.
Accepted file types: jpg, jpeg, pdf, png, gif, doc, docx.
Through my signature below, I understand and agree to the following:
The results generated under the related License Agreement arising from this Licensee Use Report (LUR) are not to be used for operational purposes. This includes, but is not limited to, using the knowledge gained by applying the ACG^® System Software to make managerial, financial or clinical decisions.
Licensor bases the terms of the related License Agreement on the information contained within this LUR. If I or my organization uses the ACG^® System Software outside the scope of activities detailed within this LUR, or if this LUR is inaccurate, or if I have otherwise misrepresented the anticipated use of the software by the Licensee, Licensor may terminate the related License Agreement immediately without prejudice.
Electronic Signature*
Title*
Organization*
Date Signed*
Date Format: MM slash DD slash YYYY
Send me emails
- Send me emails
CAPTCHA
Lead Source
Legacy Assigned
Request
Owner ID (Alan)
Owner ID (Sarah)
Owner ID (Stuart)
Compliance
Phone
This field is for validation purposes and should be left unchanged.

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Academic Research License

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Academic Research License

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Academic Research License Application

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GET THE ACG® SYSTEM

Full License

Trial License

Developer License

Academic Research License

GET THE ACG SYSTEM

REQUEST A DEMO

REQUEST DEMO

Academic Research License

BEGIN APPLICATION

Request a Demo

Request a Demo

Academic Research License Application

Get the ACG System

Get the ACG System

GET THE ACG^® SYSTEM