DATA USE AGREEMENT (DUA) FORM CMS-R-0235QENovember 28th, 2011
FiledNovember 28th, 2011This agreement must be executed prior to the disclosure of data from CMS’ Systems of Records to ensure that the disclosure will comply with the requirements of the Privacy Act, the Privacy Rule and CMS data release policies. It must be completed prior to the release of, or access to, specified data files containing protected health information and individual identifiers.