№ lp_1_09951
File format: docx
Character count: 5058
File size: 27 KB
This document is an authorization form allowing the disclosure and use of Protected Health Information (PHI) for a research study at the University of Miami and Jackson Health Systems.
Note:
Year
Topic:
Research, Health Information, Privacy
Document Type:
Authorization Form
Institution:
University of Miami, Jackson Health Systems
Target Audience:
Participants in Research Studies
Price: 8 / 10 USD
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The product description is provided for reference. Actual content and formatting may differ slightly.
Note:
Year
Organization / Institution:
U.S. Department of Labor, Office of Workers’ Compensation Programs, Division of Energy Employees Occupational Illness Compensation
Year:
2023
Region / City:
United States
Topic:
Medical authorization and billing
Document type:
Official form
Organization / Institution:
Department of Veterans Affairs
Author:
Department of Veterans Affairs
Target audience:
Healthcare providers, Veterans
Period of validity:
From date of issue
Date of approval:
Not specified
Date of amendments:
Not specified
Year:
2023
Region / City:
Iowa, Des Moines
Subject:
Proposal Certification and Authorization to Release Information
Document Type:
Certification Letter
Issuing Organization:
Iowa Workforce Development
Author:
Michael Drottz
Target Audience:
Respondents to RFP 309MD24001
Period of Validity:
N/A
Approval Date:
N/A
Date of Revision:
N/A
Note:
Year
Organization / Institution:
Minnesota Department of Education
Target Audience:
School District Superintendents, Early Education Staff
Year:
2023
Region / City:
United States
Topic:
Personnel vetting, security clearance
Document Type:
Questionnaire, Authorization Form
Agency:
Federal Government
Author:
Unknown
Target Audience:
Individuals undergoing personnel vetting
Period of Validity:
Until termination of affiliation with the Federal Government or position requirement
Approval Date:
Not specified
Amendment Date:
Not specified
Document type:
Access authorization form
System:
Enterprise Income Verification (EIV)
Program area:
Multifamily Housing
Issuing organization:
U.S. Department of Housing and Urban Development
Legal basis:
Paperwork Reduction Act of 1995; Federal Privacy Act
OMB control number:
2502-0204
Purpose:
Initial or reinstated access to the Multifamily EIV system and acknowledgment of Rules of Behavior
Target users:
Multifamily Housing Coordinators and Contract Administrator Coordinators
Submission method:
Fax or email to HUD Multifamily Helpdesk
Access duration:
Up to one year before recertification
Security framework:
HUD Security Program Policy; HUD Handbook 2400.25 Rev. 1
Data sensitivity:
Personally identifiable information
Note:
Year
Theme:
Foster Care, Residential Care
Document Type:
Authorization Form
Organization / Institution:
Texas Department of Family and Protective Services (DFPS)
Target Audience:
Caregivers, Caseworkers
Year:
2026
Region / City:
N/A
Subject:
Prior authorization requirements for lower extremity endovascular procedures
Document type:
Checklist
Organization:
N/A
Author:
N/A
Target audience:
Healthcare providers
Period of validity:
N/A
Approval date:
N/A
Date of amendments:
N/A
Year:
2023
Region / City:
University of Kentucky
Subject:
Research Study Participation
Document Type:
Consent Form
Institution:
University of Kentucky
Author:
Research Team
Target Audience:
Potential research participants
Study Duration:
Variable (hours, days, months, years)
Approval Date:
Not specified
Modification Date:
Not specified
Year:
2014
Region / City:
United States
Topic:
Medication Administration, Medical Authorization
Document Type:
Authorization Form
Organization / Institution:
245D licensed program
Author:
Not specified
Target Audience:
Individuals receiving medication assistance, legal representatives
Period of Validity:
Ongoing
Approval Date:
January 1, 2014
Date of Changes:
Not specified
Year:
Not specified
Region / City:
Not specified
Subject:
Health research, consent, data sharing
Document type:
Authorization form
Organization / Institution:
Medical College of Wisconsin
Author:
Not specified
Target audience:
Researchers, Institutional administrators
Period of validity:
Not specified
Approval date:
Not specified
Date of amendments:
Not specified
Year:
[Insert Year]
Region / City:
[Insert City, State ZIP]
Theme:
Medical Treatment Authorization
Document Type:
Authorization Request
Organization:
[Insert Payer Name]
Author:
[Insert Healthcare Provider’s Name]
Target Audience:
Medical Director or individual responsible for prior authorization
Period of Validity:
[Insert Date Range if Applicable]
Approval Date:
[Insert Date if Available]
Amendment Date:
[Insert Date if Applicable]
Note:
Year
Organization / Institution:
Oregon State University
Note:
Year
Topic:
Oncology
Document Type:
Medical Treatment Authorization Request
Target Audience:
Medical/Pharmacy Director
Note:
Year
Note:
Year
Subject:
Solar Energy, Photovoltaic Systems
Document Type:
Technical Plan
Target Audience:
Contractors, Engineers
Context:
Technical source document outlining standard plans for solar PV system installations for residential properties.
Status:
Draft
Document type:
Interpretation and guidance document
Legal basis:
Commission Implementing Regulation (EU) 2022/1426
Related legislation:
Regulation (EU) 2019/2144
Subject matter:
Type-approval of automated driving systems for fully automated vehicles
Prepared by:
Experts of the European Commission MVWG-ACV subgroup
Target audience:
Vehicle manufacturers; Technical Services; Approval Authorities
Geographical scope:
European Union
Applicability:
Voluntary guidance
Year:
2023
Scope:
Interpretation of requirements and acceptable means of compliance for ADS type-approval
Source type:
Regulatory guidance document
Year:
2013
Region / city:
United States
Topic:
IT Support and Maintenance for Healthcare Systems
Document Type:
Request for Information (RFI)
Agency / Institution:
Department of Veterans Affairs
Author:
Candice Capelli
Target Audience:
Contractors and vendors for IT services
Period of validity:
Until contract award
Approval date:
March 2010
Modification date:
Not provided
Year:
2025
Region / City:
Eugene, Oregon
Subject:
Affordable Housing, Systems Development Charges, Low-Income Housing
Document Type:
Request for Proposals (RFP)
Agency / Institution:
City of Eugene
Author:
Laura Hammond, Community Development Division of the City of Eugene
Target Audience:
Public agencies, private/for-profit, and non-profit developers
Period of Validity:
FY 2026
Approval Date:
July 16, 2025
Amendment Date:
Not specified