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If you are submitting a new study application in iRIS and need to submit Form 5, 6, 7, 8, or 9 do NOT download the form from this page. Instead, use the form in iRIS under My Assistant / Operating Procedures.
Research Privacy Forms (1-4):
Form
1 -Using or disclosing PHI for research.
Used for most clinical
research projects not involving psychotherapy
or repository research.
Form 1 -Spanish translated version
Using or disclosing PHI for research. Used for most clinical research projects not involving psychotherapy or repository research.
Form
2 -Disclosing psychotherapy notes for research
Instructions -for preparing the authorization for disclosure of psychotherapy notes
Form 2 -Spanish translated version
Form
3 -Disclosing PHI for repository research only
Form 3 -Spanish translated version
Form
4 -Combination of Forms 1 & 3. For combined research
that includes repository research
Form 4 -Spanish translated version
Research Privacy Form (OKC-VAMC):
OKC-VAMC Authorization for Release of PHI for Research
Research Privacy Form (5):
Form
5 -Waiver of authorization
Research Privacy Forms (6-10):
Form
6 -Review preparatory to research. Only to determine if
research can be conducted. Not for patient screening.
Form
7 -Research on decedent information
Form
8 -Research with de-identified information
Form
9 -Research with limited data sets
Form
10 -Data Use Agreement. For use with Form 9
as appropriate
Research Privacy Form (Tulsa):
Form 1 - St. Francis Hospital
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