Template MSU Authorization to Use or Disclose Health Information for Research

Form

Description

If Protected Health Information will be obtained from a clinic that is part of the MSU covered entity and individual authorization will be obtained, use of the template “MSU Health Team Research Authorization Form” is required.

Submission Instructions

After you have used the template to develop your MSU Authorization to Use or Disclose Health Information for Research, submit as an attachment through the irbdocs@ora.msu.edu email. Please identify the IRB project that relates to the form by "i" number (i######) or "r" number (r######).

Related Forms, Instructions, or Templates

Helpful HRPP Manual Sections