HIPAA Documents
- SUNY New Paltz Policy and Procedure on Research Subjects' Right to Privacy
- HIPAA introduction *
- Model forms for use by covered entities [ PDF or Word]
- HIPAA authorization - instructions for preparing consent documents for HIPAA compliance *
- Attachment A* - What about confidentiality of records and authorization to use/share protected health information for research? [ PDF or Word]
- Attachment B* - Consent language for banking specimens or voice/fingerprints in research [ PDF or Word]
- Attachment C* - Consent to participate in research and authorization to use and share personal health information [ PDF or Word]
- Attachment D* - Consent to participate in research and authorization to use and share personal health information (for subjects 18 years of age and older) [ PDF or Word]
- Attachment E* - Consent to participate in research and authorization to use and share personal health information (for subjects less than 18 years of age) [ PDF or Word]
- Application for HIPAA waiver of authorization [ PDF or Word]
- HIPAA de-identification certification form [ PDF or Word]
- Limited data set (LDS) request form [ PDF or Word]
- Model data use agreement [PDF or Word]
- Model request for permission to access identifiable health information of deceased individuals [ PDF or Word]
- Model request for permission to access identifiable health information for reviews preparatory to research [ PDF or Word]
