
Human
Investigation Committee
Yale University
School of Medicine
47 College Street,
Suite 204
New Haven, CT
06520-8010 USA

Phone:
(203) 785-4688

Fax:
(203) 785-2847



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HIPAA documentation & forms
| Forms |
Data Use Agreement
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PDF |
Word |
| Accounting of Disclosures Log
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PDF |
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| Internal Data Use Agreement
(For use by Yale University researchers when requesting limited data sets for research purposes from databases and repositories owned by Yale University.)
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PDF |
Word |
| Research Authorization Form - Template A.
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PDF
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Word
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Research Authorization Form - Template B.
(simpler language)
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PDF |
Word |
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Research Authorization Form - Template B.
(Spanish version)
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PDF |
Word |
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Request for Access to Protected Health Information for a Research Purpose
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PDF |
Word |
| Providing
Access to Protected Health Information for Research Purposes
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PDF |
Word |
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Visit the HIPAA Web site.

Last modified:
Friday, 12-Sep-2008 15:13:58 EDT
. (jj)


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