HIPAA Authorization Agreement – Authorization to Use and Release Health Information for a Research Study Insert Study TitleHipaa Authorization Agreement • October 28th, 2020
Contract Type FiledOctober 28th, 2020State and Federal laws, including the Health Insurance Portability and Accountability Act (HIPAA), require researchers to protect your health information. This form describes how researchers, with your authorization (permission), may use and release your protected health information for this research study. Please read this form carefully.