Please note that the University of Chicago does not authorize its researchers to sign agreements on its behalf. While researchers are encouraged to read the agreements associated with their projects in order to understand and adhere to their terms, all agreements must be reviewed, negotiated, and signed by the appropriate University Research Administration official.
First, please determine whether you are sending de-identified data, a limited data set, or protected health information. Then choose the appropriate template. Please refer to the HHS website https://www.hhs.gov/hipaa/for-professionals/privacy/special-topics/de-identification/index.html for further clarity, or email Kathryn Jones at email@example.com. If the data you are sending do not fit in any of those three categories (de-identified data, a limited data set, or protected health information), please email firstname.lastname@example.org with a detailed description of the data.
- At the top of the page, please include the IRB protocol number for the IRB protocol under which the data was collected.
- Fill in the University of Chicago PI’s information in the Provider Scientist field.
- Note that the template’s default agreement term is three years. If different, change accordingly.
- Fill in the Recipient’s information in the Recipient and Recipient Scientist fields.
- Write in the project’s title.
- Provide a description of the data in Article 1 and be sure to indicate if its de-identified data, a limited data set, or protected health information.
- Provide the Recipient’s Scope of Work in Article 2.
- In Article 3, check the box for electronic submission or, if the data will be sent in hard copy form, select that option and write out the mailing address. PLEASE DO NOT WRITE OUT THE MAILING ADDRESS IF THE DATA WILL BE SENT ELECTRONICALLY. Also include any special instructions for the transfer.
- In Article 4, indicate if there will be any costs to be reimbursed by the Recipient.
- In Article 5, indicate what should happen to data upon conclusion of the project. Our institution’s preference is for data to be deleted at the project’s conclusion.
- Please confirm that Attachment 2 matches the type of data being transferred.
- Indicate if anyone outside of the Recipient organization will have access to the data on behalf of the Recipient.