Data Usage AgreementEngland and Wales • April 11th, 2019
Jurisdiction FiledApril 11th, 2019Access 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 c/o 2nd Floor, Becketts House, 2-14 Ilford Hill, Ilford, Essex, IG1 2QX. 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. Requester name: Homerton Hospital CCG Area: BHR Data Sharing Agreement Reference Number: ( to be filled out by IG team) 05 DSA Status: Authorised Please provide details of the field(s) of data to which you a