№ files_lp_4_process_1_32076
Official authorization form used to grant permission for handling VA sensitive research information outside VA facilities.
Date: Not specified
From: Not specified
To: Director, Eastern Colorado Health Care System (554/00)
Thru: ACOS/R&D (554/151), Information Security Officer (554/001), Privacy Officer (554/136D), Denver Area Deputy Manager (554/OI&T)
Protocol #: Not specified
Type of Information: VA Sensitive Information
Information Format: Electronic, Paper-Based
Research Materials Included: Database, Electronic Case Report Forms, Informed Consent Documents, Paper Case Report Forms
Purpose: Transport, transmit, store, or utilize VA sensitive information for research
Acknowledgements: Compliance with VA Handbook 6500, Return of research data upon study completion, Transfer of PI responsibilities if leaving VA
Signatories: Robert Keith, MD; Eduardo Lorenzo; Nichelle Downing; Prince Rogers; Donald Huckaby
Organization: Eastern Colorado Health Care System, Department of Veterans Affairs
Period of Action: Duration of study
Legal References: VA Directive 6500, HIPAA Privacy Rule, Privacy Act, Freedom of Information Act
Price: 8 / 10 USD
The file will be delivered to the email address provided at checkout within 12 hours.

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