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APPROVED BY THE YALE UNIVERSITY IRB 1×10/2020 HIC # 0301024156COMPOUND CONSENT AND AUTHORIZATION FOR PARTICIPATION IN A RESEARCH PROJECT YALE UNIVERSITY SCHOOL OF MEDICINE DEPARTMENT OF PSYCHIATRY
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How to fill out compound consent and authorization

01
To fill out a compound consent and authorization form, follow these steps:
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Begin by writing the heading 'Compound Consent and Authorization Form' at the top of the page.
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Next, include a brief introduction explaining the purpose of the form and its importance.
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Create sections for each type of consent and authorization required, such as medical treatment, release of medical records, and sharing of personal information.
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Under each section, provide clear instructions on how to provide consent or authorization, including any specific information or documents needed.
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Include spaces for the individual's name, contact information, and date of signing at the bottom of the form.
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Additionally, provide a section for any additional comments or restrictions the individual would like to include.
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Review the form to ensure all necessary information and instructions are included.
09
Print the form and ask the individual to read and understand each section before signing.
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Once signed, make copies for both the individual and the authorized parties involved.
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Store the original document in a secure location for future reference.

Who needs compound consent and authorization?

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Compound consent and authorization forms may be needed by various individuals or organizations, including:
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- Healthcare facilities and providers: They require compound consent and authorization forms to obtain permission for medical treatment, release of medical records, and sharing of personal information.
03
- Research institutions: They may require compound consent and authorization forms from participants to gather data, conduct studies, or use personal information for research purposes.
04
- Legal organizations: They may need compound consent and authorization forms to represent individuals in legal matters and share confidential information with third parties.
05
- Insurance companies: They may use compound consent and authorization forms to gather medical records and personal information for claim processing or investigation purposes.
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- Educational institutions: They may require compound consent and authorization forms from students or parents to access medical information or request special accommodations.
07
- Employers: They may use compound consent and authorization forms to gather medical information or perform background checks as part of the hiring process.
08
- Financial institutions: They may require compound consent and authorization forms to collect and share personal information for identity verification or fraud prevention.
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Compound consent and authorization is a legal process where an individual gives permission for a specific action or access to personal information by multiple parties.
Compound consent and authorization may be required to be filed by individuals or organizations seeking permission to access personal information from multiple sources.
Compound consent and authorization forms can be filled out by providing the necessary information requested, including details about the parties involved and the specific authorization being granted.
The purpose of compound consent and authorization is to ensure that individuals have control over who can access their personal information and for what purposes.
Information reported on compound consent and authorization may include the names of the parties involved, the specific actions or information being authorized, and any limitations or restrictions on the authorization.
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