From ad89160b6e85fa63ac990b6ccf2941ae16817755 Mon Sep 17 00:00:00 2001 From: Tom Pollard Date: Wed, 14 Dec 2016 16:01:35 -0500 Subject: [PATCH] add template for responses --- DataUseAgreement.md | 54 ++++++++++++++++++++++----------------------- 1 file changed, 27 insertions(+), 27 deletions(-) diff --git a/DataUseAgreement.md b/DataUseAgreement.md index c8eeef9..f4a2c89 100644 --- a/DataUseAgreement.md +++ b/DataUseAgreement.md @@ -15,31 +15,31 @@ If I am granted access to the MIMIC Clinical Databases, I agree to the terms and 5. If I find information within restricted data from PhysioNet that I believe might permit identification of any individual, I will report the location of this information promptly by email to mimic-support@physionet.org, citing the location of the specific information in question so that it can be investigated and removed if necessary. 6. I have requested access to restricted data from PhysioNet for the sole purpose of lawful use in scientific research, and I will use my privilege of access, if it is granted, for this purpose and no other. 7. I have completed a training program in human research subject protections and HIPAA regulations, and I am submitting proof of having done so. -8. This agreement may be terminated by either party at any time, but my obligations with respect to restricted data from PhysioNet shall continue after termination. - -My name: -My PhysioNetWorks username: -Telephone number, including country/area code (required): -Institution: -Title or position: -Street address: -City: -State/Province: -ZIP/postal code: -Country: - -Name of human studies training course completed: -Date completed: - -* Supervisor's name: -* Supervisor's telephone number: -* Supervisor's email address: -* Supervisor's title: -(* information required for students and postdocs) - -General research area for which the data will be used: - -Date of this agreement: - +8. This agreement may be terminated by either party at any time, but my obligations with respect to restricted data from PhysioNet shall continue after termination. + +My name: +My PhysioNetWorks username: +Telephone number, including country/area code (required): +Institution: +Title or position: +Street address: +City: +State/Province: +ZIP/postal code: +Country: + +Name of human studies training course completed: +Date completed: + +* Supervisor's name: +* Supervisor's telephone number: +* Supervisor's email address: +* Supervisor's title: +(* information required for students and postdocs) + +General research area for which the data will be used: + +Date of this agreement: + [ ] I have attached a certificate of completion of a human subjects -protections course. +protections course.