Data Usage AgreementData Usage Agreement • June 17th, 2020 • London
Contract Type FiledJune 17th, 2020 JurisdictionAccess request form In order to request access to certain data held in the BHR Joint Database, this form should be completed and submitted to Barking and Dagenham, Havering and Redbridge Clinical Commissioning Groups at North House, St Edwards Way, RM1 3AE. Please note that the terms and conditions appended to this Request Form will apply with respect to access to the BHR Joint Database and any data held therein. Please read through them carefully and ensure that you understand and agree with them. By signing and submitting this Request Form, you are agreeing to comply, and to ensure that each person who will access the BHR Joint Database and data held therein will comply, with these terms and conditions as amended and updated from time to time. Practice Name: [Queen Mary University of London (for Genes & Health)] CCG Area:A12 5NG BHR CCGs Data Sharing Agreement Reference Number: 019 DSA Status: Pending Please provide details of the field(s) of data to which you are requesting access