№ files_lp_4_process_2_68712
File format: docx
Character count: 4676
File size: 55 KB
Form providing federal regulatory guidance and a structured template for requesting an IRB waiver of HIPAA authorization to access individually identifiable health information in research studies.
Year:
2024
Institution:
University at Buffalo
Program:
Human Research Protections Program
Document Type:
Guidance / Form
Audience:
Researchers submitting waiver requests
Related Regulations:
HIPAA
Purpose:
Request waiver of authorization for use of individually identifiable health information in research
Revision History:
R00 (3/25/14) original issue; R01 (6/10/19) policy alignment; annual reviews 2020–2024
Instructions Included:
Yes
Price: 8 / 10 USD
The file will be delivered to the email address provided at checkout within 12 hours.
The file will be delivered to the email address provided at checkout within 12 hours.
Don’t have cryptocurrency yet?
You can still complete your purchase in a few minutes:- Buy Crypto in a trusted app (Coinbase, Kraken, Cash App or any similar service).
- In the app, tap Send.
- Select network, paste our wallet address.
- Send the exact amount shown above.
The final amount may vary slightly depending on the payment method.
The file will be sent to the email address provided at checkout within 24 hours.
The product description is provided for reference. Actual content and formatting may differ slightly.
Year:
2017
Region / City:
United States
Topic:
Data privacy, healthcare information
Document Type:
Fact Sheet
Agency/Organization:
VHA Privacy Office
Author:
VHA
Target Audience:
VA employees
Effective Period:
May 2017
Approval Date:
May 2017
Date of Last Update:
May 2017
Year:
2017
Region / City:
United States
Topic:
Data privacy, healthcare information
Document Type:
Fact Sheet
Agency/Organization:
VHA Privacy Office
Author:
VHA
Target Audience:
VA employees
Effective Period:
May 2017
Approval Date:
May 2017
Date of Last Update:
May 2017
Year:
2019
Region / City:
North Carolina
Subject:
Data Privacy and Security
Document Type:
Best Practices Guide
Institution:
North Carolina Department of Public Instruction
Author:
Division of School Data, Research and Federal Policy
Target Audience:
NC Department of Public Instruction (DPI) staff, school and LEA staff
Period of Validity:
Ongoing
Approval Date:
August 30, 2019
Date of Modifications:
Not specified
Year:
2015
Region / City:
Weslaco, Texas
Subject:
Medicaid Reimbursement, Special Education Services
Document Type:
Consent Form
Organization / Institution:
Weslaco Independent School District
Author:
Weslaco ISD
Target Audience:
Parents/Guardians of students receiving special education services
Period of Validity:
As long as the child is receiving SHARS services
Approval Date:
07/08/2015
Modification Date:
None
Year:
2026
Institution:
The City University of New York
Type of Document:
Informed Consent Form
Principal Investigator:
Not specified
Target Audience:
Research participants providing identifiable private information or biospecimens
Purpose:
Obtain broad consent for future research use of identifiable private information and biospecimens
Scope:
Future research studies with potential sharing among academic, government, private, and nonprofit researchers
Risks:
Potential privacy violations
Benefits:
Advancement of scientific knowledge for society
Alternatives:
Participants may refuse broad consent without affecting current or future benefits
Withdrawal Policy:
Participants may withdraw consent for future research, with limitations on previously shared data
Jurisdiction:
United States
Legal framework:
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Regulatory references:
45 CFR § 160.103; 45 CFR § 164.514; 45 CFR § 164.530(c); Subpart D of 45 CFR § 164
Subject matter:
Protected Health Information (PHI) and Personally Identifiable Information
Document type:
Legal agreement terms and conditions
Agreement type:
Data transfer and use agreement
Parties:
Provider; Recipient
Data classification:
Protected Health Information (PHI)
Purpose of data use:
Project-related use consistent with obtained consents or authorizations
Compliance requirements:
HIPAA Privacy Regulations
Institutional oversight:
Institutional Review Board (IRB) approval or waiver where required
Data access:
Authorized Persons only
Disclosure restrictions:
Use and disclosure limited to the terms of the agreement and applicable law
Incident notification:
Unauthorized use or disclosure must be reported to Provider within five business days
Data protection measures:
Reasonable safeguards to prevent prohibited uses and disclosures
Data retention and disposal:
Removal and secure destruction or return of identifiable data elements as directed by Provider
Amendment provision:
Agreement subject to amendment to maintain HIPAA compliance
Documentation requirement:
Recipient must provide IRB-approved protocol documentation upon request
Year:
2019
Organization:
Illinois CPA Society, Accounting Principles Committee
Document Type:
Comment letter
Addressee:
Financial Accounting Standards Board
Authors:
Brian Kot, CPA; William Keirse, CPA
Topic:
Accounting for goodwill and intangible assets
Target Audience:
FASB members and staff
Period Covered:
Current accounting standards and proposed changes
Reference Number:
2019-720
Context:
Letter provides professional perspectives on accounting standards proposals for intangible assets and goodwill, discussing cost-benefit considerations and differing views on amortization and impairment testing.
Year:
2019
Region / City:
United States
Topic:
Immigration Services
Document Type:
Instruction Manual
Organization:
U.S. Citizenship and Immigration Services (USCIS)
Author:
U.S. Citizenship and Immigration Services
Target Audience:
Individuals applying for immigration benefits
Effective Period:
Ongoing, with periodic updates
Approval Date:
10/15/2019
Date of Changes:
10/15/2019
Note:
Year
Region / City:
Colorado
Topic:
Family Violence Option, Cash Assistance, Work Activities
Document Type:
Policy
Organization / Institution:
Colorado Department of Human Services
Target Audience:
State employees, public, relevant stakeholders
Year:
2023
County:
[County Name]
Club:
[Club Name]
Location of Activity:
[Location Name]
Date of Activity:
[Date]
Participant Name:
[Participant Name]
Participant Age:
[Participant Age]
Participant is a 4-H member:
Yes/No
Participant is NOT a 4-H member:
Yes/No
Participant knows how to swim and can swim at least one length of the pool:
Yes/No
Participant does NOT know how to swim:
Yes/No
Participant does NOT have permission to participate in water activities:
Yes/No
Governing Law:
Iowa
Program:
[Program Name]
Health Requirements:
Participant must be healthy and reasonably fit to participate safely
Inherent Risks:
Climbing, Ropes Course, Swimming
Emergency Contact:
[Emergency Contact Name]
Signature of Parent or Guardian:
[Signature]
Date:
[Date]
Signature of Participant:
[Signature]
Year:
2014
Region / City:
United States
Subject:
Research ethics, IRB review process
Document type:
Checklist
Author:
Not specified
Target audience:
IRB members, Designated Reviewer, researchers
Period of validity:
Ongoing
Approval date:
3/25/14
Amendment date:
11/1/2024
Year:
2023
Region / City:
Bemidji
Topic:
Liability Waiver, Sports Facility
Document Type:
Legal Agreement
Organization / Institution:
Bemidji Indoor Sports Commission
Author:
Not specified
Target Audience:
Participants of the Neilson Fieldhouse, parents/legal guardians of minors
Period of validity:
Not specified
Approval Date:
Not specified
Modification Date:
Not specified
Year:
2024
Region / City:
Georgia
Theme:
Health care, Medicaid services, Waiver programs
Document Type:
Program Update
Agency / Organization:
Georgia Department of Community Health (DCH)
Author:
Vonnie Stelly, Andrea Streeter, Briana Coogler, Marina Kim, Shandria Beasley, Taesha Ward, Donna Elrod, Sharon Collins
Target Audience:
Health care providers, Medicaid providers, Waiver program administrators
Period of Validity:
Ongoing
Approval Date:
07/01/2024
Amendment Date:
Ongoing
Note:
Year
Theme:
Home and Community-Based Waiver, Brain Injury Care
Document Type:
Policy Guide
Institution:
Department of Health and Human Services (DHHS)
Target Audience:
Adults with brain injuries, caregivers, healthcare providers
Year:
2025
Region / City:
England and Wales
Topic:
Criminal record check waiver for Call to the Bar applicants
Document type:
Guideline
Institution:
Bar Standards Board (BSB)
Author:
Bar Standards Board
Target audience:
Inns’ student members applying for Call in 2025, transferring qualified lawyers
Period of validity:
2025
Approval date:
Not specified
Date of changes:
Not specified
Note:
Year
Year:
2023
Region / City:
Texas
Subject:
Construction and payment waiver
Document Type:
Legal Affidavit
Organization / Institution:
Texas General Land Office (GLO)
Author:
Texas General Land Office
Target Audience:
Contractors and subcontractors in construction projects
Period of Validity:
N/A
Approval Date:
N/A
Date of Modifications:
N/A
Type of document:
Referral form and liability waiver
Organization:
Community Warehouse Project (CWP) of Cheater County
Jurisdiction:
Commonwealth of Pennsylvania
Intended audience:
Clients receiving furniture through an agency referral
Related roles:
Agency case managers and sponsors
Subject matter:
Furniture and home goods delivery and acceptance
Condition of goods:
Used items provided as-is without warranties
Return policy:
Furniture and home goods cannot be returned to CWP
Client obligations:
Acceptance of all delivered furniture and preparation of residence for delivery
Risk allocation:
Assumption of all risks related to acceptance, transportation, and use
Legal provisions:
Release, indemnification, and hold harmless agreement
Age requirement:
Client is 18 years of age or signs as parent or guardian of a minor
Language assistance:
Client responsible for bringing a translator if needed
Form requirements:
Three forms required to be completed and submitted at time of request
Jurisdiction:
State of Kansas
Legal basis:
K.S.A. 75-5276; K.S.A. 75-5277; K.S.A. 76-769
Issuing body:
Kansas Correctional Industries
Document type:
Administrative waiver request form and statutory guidance
Subject matter:
Mandatory procurement and waiver process for office furniture and related goods
Affected entities:
State agencies of Kansas
Exempt entities:
Universities in Kansas
Goods covered:
Office furniture, office systems, paint, janitorial products
Waiver decision authority:
Kansas Correctional Industries; Secretary of Administration; Director of Purchases
Decision timeframe:
Five working days from receipt
Appeal authority:
Secretary of Administration and Director of Purchases
Applicable standards:
Comparable quality, price, and timeliness
Geographic scope:
Kansas