From 73d5135721c05a802300c5ed0ed292909e152fb5 Mon Sep 17 00:00:00 2001
From: Jarvis Raymond <jarvisraymond@uchicago.edu>
Date: Mon, 6 Jul 2026 16:30:57 -0500
Subject: [PATCH] feat(healSampleConfig): Added
 studyRegistrationAccessRequestForm

---
 .../studyRegistrationAccessRequestForm.json   | 104 ++++++++++++++++++
 1 file changed, 104 insertions(+)
 create mode 100644 devplanetv2/dev-environments/jarvis/sampleConfigs/heal/studyRegistrationAccessRequestForm.json

diff --git a/devplanetv2/dev-environments/jarvis/sampleConfigs/heal/studyRegistrationAccessRequestForm.json b/devplanetv2/dev-environments/jarvis/sampleConfigs/heal/studyRegistrationAccessRequestForm.json
new file mode 100644
index 00000000..16548676
--- /dev/null
+++ b/devplanetv2/dev-environments/jarvis/sampleConfigs/heal/studyRegistrationAccessRequestForm.json
@@ -0,0 +1,104 @@
+{
+  "remoteSupportService": {
+    "service": "zenDesk",
+    "configuration": {
+      "zendeskSubdomainName": "heal-support"
+    }
+  },
+  "disclaimer": "Information provided on this page will be used for correspondence regarding your request and may be shared with the NIH and/or the HEAL Data Stewards.",
+  "form": [
+    {
+      "type": "markdown",
+      "text": "## Study Registration Access Request"
+    },
+    {
+      "type": "markdown",
+      "text": " Please fill out this form to request and be approved for access to register your study with the HEAL Platform.",
+      "className": "text-sm"
+    },
+    {
+      "type": "TextInput",
+      "label": "Study Name - Grant Number",
+      "initialValue": "studyName",
+      "disabled": true,
+      "required": true,
+      "variable": "studyName"
+    },
+    {
+      "type": "TextInput",
+      "label": "Registrant First Name",
+      "required": true,
+      "variable": "registrantFirstName"
+    },
+    {
+      "type": "TextInput",
+      "label": "Registrant Last Name",
+      "required": true,
+      "variable": "registrantLastName"
+    },
+    {
+      "type": "Email",
+      "label": "E-mail Address",
+      "required": true,
+      "variable": "emailAddress"
+    },
+    {
+      "type": "TextInput",
+      "label": "Affiliated Institution",
+      "required": true,
+      "variable": "affiliatedInstituation"
+    },
+    {
+      "type": "RadioGroup",
+      "label": "Role on Project",
+      "text": [
+        "Principal Investigator",
+        "Co-Principal Investigator",
+        "Co-Investigator",
+        "Administrator",
+        "Clinical Collaborator",
+        "Clinical Coordinator",
+        "Data Analyst",
+        "Data Manager",
+        "Research Coordinator",
+        "Other..."
+      ],
+      "required": true,
+      "variable": "roleOnProject"
+    }
+  ],
+  "success": {
+    "content": [
+      {
+        "type": "markdown",
+        "text": [
+          "# Your access request has been submitted!",
+          "Thank you for your submission. Requests take up to 1 business day to complete. You will be notified when approved. If you do not receive notification within 1 business day of your request, please reach out to [heal-support@gen3.org](mailto:heal-support@gen3.org)."
+        ],
+        "className": "text-center"
+      }
+    ],
+    "button": {
+      "variant": "filled",
+      "href": "/Discovery",
+      "text": "Go to Discovery Page"
+    }
+  },
+  "duplicateSubmission": {
+    "content": [
+      {
+        "type": "markdown",
+        "text": [
+          "# A problem has occurred while submitting the request!",
+          " There is already a pending request for this user to access this study. We are processing your request. You will be notified when approved. If you do not receive notification within 1 business day of your initial request, please reach out to [heal-support@gen3.org](mailto:heal-support@gen3.org)."
+        ],
+        "className": "text-center"
+      }
+    ],
+    "button": {
+      "variant": "filled",
+      "href": "/Discovery",
+      "text": "Go to Discovery Page"
+    }
+  }
+}