National Clinical Trials Network (NCTN)Data Use Agreement (Dua) • January 25th, 2023
The National Cancer Institute (NCI), and RECIPIENT(S), hereby enter into this Data Use Agreement (DUA) as of the effective date specified on the final signatures page.
DATA USE AGREEMENT (DUA) PROVISIONSData Use Agreement (Dua) • March 17th, 2023
Attachment BData Use Agreement (Dua) • August 15th, 2014
This attachment supplements the above-referenced Data Use Agreement (DUA) between the Centers for Medicare and Medicaid Services and the User (as set forth in the DUA). Upon execution by both parties, to the extent this Attachment is inconsistent with any terms in the DUA, this Attachment modifies and overrides the DUA.
SEER-MEDICARE HEALTH OUTCOMES SURVEY DATA USE AGREEMENT (DUA) PRINCIPAL INVESTIGATORData Use Agreement (Dua) • September 17th, 2021
Information pertaining to an individual’s health status and medical treatment is sensitive. Therefore, specific laws, including the Privacy Act of 1974 and the Health Insurance Portability and Accountability Act of 1996, have been enacted to ensure the confidentiality of health information. In utilizing health data for research purposes, it is absolutely necessary to ensure, to the extent possible, that uses of such data will be limited to research. Uses for any other reason, particularly those resulting in personal disclosures, will be prosecuted to the full extent of the law. In addition, release of information about the health plans, hospitals, and other providers that provide health care, may compromise the willingness of these organizations to cooperate with the activities of the cancer registries. Therefore, considerations regarding the privacy of providers are also of greatimportance.
INSTRUCTIONS FOR COMPLETING THE DISPROPORTIONATE SHARE HOSPITAL DATA USE AGREEMENT (DUA)Data Use Agreement (Dua) • February 3rd, 2010
This agreement is needed as part of the review of your data request to ensure compliance to the requirements of the Privacy Act, and must be completed prior to the release of specified data files containing individual identifiers.
DATA USE AGREEMENT (DUA) CERTIFICATE OF DISPOSITION (COD) FOR DATA ACQUIRED FROM THE CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS)Data Use Agreement (Dua) • May 30th, 2012
This certificate is to be completed and submitted to CMS to certify the destruction/discontinued use of all CMS data covered by the listed Data Use Agreement (DUA) at all locations and/or under the control of all individuals with access to the data. This includes any and all original files, copies made of the files, any derivatives or subsets of the files and any manipulated files. The requester may not retain any copies, derivatives or manipulated files – all files must be destroyed or properly approved in writing by CMS for continued use under an additional DUA(s). CMS will close the listed DUA upon receipt and review of this certificate and provide e-mail confirmation to the submitter of the certificate.
PLEASE REVIEW THE LEA MEDI-CAL BILLING OPTION PROVIDER MANUAL FOR COMPLETE LEA PROGRAM AND POLICY INFORMATION**Data Use Agreement (Dua) • December 10th, 2013
DATA USE AGREEMENT (DUA) SIGNATURE ADDENDUM FOR DATA ACQUIRED FROM THE CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS)Data Use Agreement (Dua) • October 17th, 2016
• Requestor: The person authorized to legally bind their organization to the terms specified in the DUA. Please note there can only be one Requestor on each DUA.
NCI PATTERNS OF CARE (POC) DATA USE AGREEMENT (DUA) PRINCIPAL INVESTIGATORData Use Agreement (Dua) • October 3rd, 2023
Information pertaining to an individual’s health status and medical treatment is sensitive. Therefore, specific laws, including the Privacy Act of 1974 and the Health Insurance Portability and Accountability Act of 1996, have been enacted to ensure the confidentiality of health information. In utilizing health data for research purposes, it is absolutely necessary to ensure, to the extent possible, that uses of such data will be limited to research. Uses for any other reason, particularly those resulting in personal disclosures, will be prosecuted to the full extent of the law. In addition, release of information about providers, i.e., the physicians and hospitals that provide care for cancer patients, may compromise the willingness of these providers to cooperate with the activities of the cancer registries. Therefore, considerations regarding the privacy of providers are also of great importance.
HSC DATA AGREEMENT PROCESS Data Use Agreement (Dua) • September 22nd, 2017
NINDS Parkinson’s Disease Biomarkers Program Genetic, Genomic and Neuroimaging Data Use Agreement (DUA)Data Use Agreement (Dua) • September 14th, 2023
Data Transfer/Sharing ChecklistData Use Agreement (Dua) • March 18th, 2024
NOTE: For any data transfer/sharing questions or for help filling out this section, please email all contacts listed above.
CMS Data Use Agreement (DUA) Category CodesData Use Agreement (Dua) • May 27th, 2012
DATA USE AGREEMENT (DUA) WITH NON-FEDERAL ENTITIES AGREEMENT FOR DATA EXCHANGE BETWEEN VETERANS HEALTH ADMINISTRATION (VHA), <INSERT FACILITY OR PROGRAM OFFICE NAME> AND <INSERT NON-FEDERAL ENTITY NAME>Data Use Agreement (Dua) • April 6th, 2015
This Agreement establishes the terms and conditions under which the VHA <INSERT FACILITY/PROGRAM OFFICE NAME> will provide, and <INSERT ENTITY NAME>, its contractors and agents, will use VHA data <PROVIDE DESCRIPTION OF PROJECT INCLUDING TYPE OF DATA AND HOW IT WILL BE USED>.
Data Use Agreement (DUA) Contacts: Sponsored Projects Office Aida Andujo, Manager, AAndujo@salud.unm.edu Siiri Wilson, Contract Specialist, SiWilson@salud.unm.edu Privacy Office Laura Putz, Privacy Officer, LPutz@salud.unm.edu Gayle Shipp, Privacy...Data Use Agreement (Dua) • April 13th, 2021
Provide all information requested if the research involves transferring/sharing of data with an external entity (institution, company, etc.).
Prostate Disease Oriented Team DATA USE AGREEMENT (DUA) PRINCIPAL INVESTIGATORData Use Agreement (Dua) • February 11th, 2015
Information regarding persons with cancer is sensitive. Therefore, specific laws have been enacted to insure the confidentiality of individuals included in cancer registry data. In utilizing data on such individuals for research purposes, it is absolutely necessary to insure, to the extent possible, that uses of such data will be limited to research. Uses for any other reason, particularly those resulting in personal disclosures, will be prosecuted to the full extent of the law. In addition, release of information about the providers, i.e. the physicians and hospitals that provide care for cancer patients, may compromise the willingness of these providers to cooperate with the activities of the cancer registries. Therefore, considerations regarding the privacy of providers are also of great importance.
Appendix D: Data Use Agreement (DUA) SamplesData Use Agreement (Dua) • November 22nd, 2023
The purpose of this letter is to update you on the status of efforts to develop a Data Sharing Agreement (DSA) template between Tribal Epidemiology Centers (TECs) and the Indian Health Service (IHS).
SEER-MEDICARE DATA USE AGREEMENT (DUA) PRINCIPAL INVESTIGATORData Use Agreement (Dua) • May 18th, 2020
Information pertaining to an individual’s health status and medical treatment is sensitive. Therefore, specific laws, including the Privacy Act of 1974 and the Health Insurance Portability and Accountability Act of 1996, have been enacted to ensure the confidentiality of health information. In utilizing health data for research purposes, it is absolutely necessary to ensure, to the extent possible, that uses of such data will be limited to research. Uses for any other reason, particularly those resulting in personal disclosures, will be prosecuted to the full extent of the law. In addition, release of information about providers, i.e., the physicians and hospitals that provide care for cancer patients, may compromise the willingness of these providers to cooperate with the activities of the cancer registries. Therefore, considerations regarding the privacy of providers are also of great importance.
DATA USE AGREEMENT (DUA) LIMITED DATA SET (LDS) TERMS AND CONDITIONSData Use Agreement (Dua) • July 24th, 2023
This Agreement governs the requesting organization’s (“you/your”) receipt and use of data from the Centers for Medicare & Medicaid Services (“CMS”), a component of the U.S. Department of Health and Human Services (“HHS”). This Agreement covers the CMS data files you requested and the corresponding purposes for their use, as specified in the Enterprise Privacy Policy Engine (“EPPE”) system.
SPO DATA AGREEMENT PROCESS – HUMAN SUBJECTSData Use Agreement (Dua) • September 7th, 2020
Data Use Agreement (DUA) between CDC National Healthcare Safety Network and New York City Department of Health & Mental Hygiene DUA Rights Template - Patient Safety ComponentData Use Agreement (Dua) • August 2nd, 2019
Compliance Agreement CoversheetData Use Agreement (Dua) • November 2nd, 2018
Please use this form each time you submit a data or specimen sharing agreement to Compliance. Having this information attached to agreements will reduce the time it takes for us to complete our review. Email the agreement and this cover page to CHR_ComplianceApprovals@kpchr.org.
Data Use Agreement (DUA) To-Be Business ProcessData Use Agreement (Dua) • April 6th, 2022
CMS Data Use Agreement (DUA) Authorization CodesData Use Agreement (Dua) • May 28th, 2012
Harvard T.H Chan School of Public HealthResearch Administration Process: Data Use Agreement (DUA) – Incoming Data Originally issued: 05/24/2013 Last revised: 04/04/2022Data Use Agreement (Dua) • April 4th, 2022
This updated process for data use agreements (DUA) is for when a Harvard Chan researcher requests access to another party’s data - referred to as INCOMING DATA. There is a separate process similar to this one dealing with Harvard Chan researchers sending data out to another party.
DATA USE AGREEMENT (DUA)Data Use Agreement (Dua) • February 19th, 2021
Will the receipt of inbound data require particular security capabilities or infrastructure beyond that of data typically housed or received at Northwestern? ☐Yes ☐No ☐Don’t Know
Arkansas Department of HealthData Use Agreement (Dua) • July 15th, 2013
access to Protected Health Information (PHI) for use with the state of Arkansas’ Communicable Disease Control processes. The Public Health reporting and analyses of the reportable disease transmitted by the corporation listed above will be conducted in accordance with the HIPAA Regulations.
ContractData Use Agreement (Dua) • January 13th, 2016
Penn MedecineAcademic Computing Services SOP: PMACS Data Use Agreement (DUA) Revision # 1 Implementation Date Page 1 of 2 Last Reviewed/Update Date SOP Owner David Wargo Approval
NICER DATA USE AGREEMENT (DUA) FOR PROJECT LEADERData Use Agreement (Dua) • December 1st, 2011
This DUA relates exclusively to data use as specified in the attached approved NICER-related research request. NICER data may involve two distinct categories of data: NICER only data and NICER plus data. NICER only data refers to use of any pooled portion of the NICER database held by the coordinating centre (NCC) under NICER-registry contract agreement. Whereas NICER plus data refers to requests proposing use of any portion of the pooled NICER database plus any additional data outside these (i.e. any data not contained in the NICER database; e.g. date-of-birth for linkage study, treatment variables for pattern of care study).
Centers for Medicare & Medicaid Services (CMS) Data Use Agreement (DUA) RequirementsData Use Agreement (Dua) • May 20th, 2012
Data Use Agreement (DUA) Attachment Outlines & InstructionsData Use Agreement (Dua) • February 28th, 2017
This text of this attachment must include the abridged name of data provider’s legal entity and abridged name of data requestor’s legal entity. It must identify via a bulleted listing all covered data sets. It must define the targeted time periods of the stored data to be released and the periodicity (i.e., recurring frequency) of the data releases. If a defined data dictionary is known, a reference to this attached data dictionary is to be included. This data dictionary, if any, is to be attached to the DUA. If there is to be a separate agreement between the legal entity of the data requestor and the legal entity of the data provider for financial compensation of the data provider, the parties and their duties and responsibilities must also be delineated.
ContractData Use Agreement (Dua) • January 25th, 2022
You need to use a Data Use Agreement (DUA) anytime you are sharing data that are NOT de- identified in a manner that was not explicitly covered in the consent form. Sharing of de- identified data does not require a DUA. A limited data sets (LDS), applied to only HIPAA covered private health information may be shared only after a DUA is in place. The first step is to determine what type of data you are working with. DUAs are most used for the sharing of HIPAA covered information such as identifiable private health information (PHI) but may be used for other types of personally identifiable data, such as student educational records. This document is specific to PHI. Contact the IRB Office if your data is not PHI for further instructions.
Data Use Agreement (DUA) between CDC National Healthcare Safety Network and Washington State Department of Health DUA Rights Template - Patient Safety ComponentData Use Agreement (Dua) • September 6th, 2019
*Note: Access to the prior year’s annual survey data will be included to allow calculation for current year SIRs - Patient Safety
DATA USE AGREEMENT (DUA)Data Use Agreement (Dua) • February 9th, 2023
Is there a collaborator or organization outside of Northwestern University who contributed to the generation of the data who may need to approve the DUA? ☐Yes ☐No If yes, please provide their name, institution, and email address:
ContractData Use Agreement (Dua) • February 1st, 2021
You need to use a Data Use Agreement (DUA) anytime you are sharing data that are NOT de- identified in a manner that was not explicitly covered in the consent form. Sharing a de-identified data set does not require a DUA, but limited data sets (LDS) may be shared only after a DUA is in place. The first step is to determine what type of data you are working with.
