Common Contracts
1 similar Request and Data Use Agreement contracts
LIMITED DATA SET REQUEST AND DATA USE AGREEMENTRequest and Data Use Agreement • November 25th, 2020
Instructions: Carefully review and complete this Request for a Limited Data Set of PHI and Data Use Agreement. If you have any questions about how to complete this request, or the Data Use Agreement requirements, contact the Privacy Officer by phone at 504- 568-2350. LSUHSC-NO reserves the right to approve, approve with modifications, or deny this request. Please complete this entire document to facilitate review of your request.
