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REQUEST FOR DE-IDENTIFIED DATA SET FROM THE MONTANA CENTRAL TUMOR REGISTRY Date Investigator Affiliation Address City State Zip Telephone - E-mail Title of Project Is this a First Request or a Revised Request If Investigator is a graduate student name of Chair/Preceptor DPHHS Use Only Sign and Date Chair Data Use Review Committee Chief Chronic Disease Administrator Public Prevention Bureau Health and Safety Approved Provisional approval Disapproved Refer to Legal Counsel Disposition...

How to fill out request for de-identified data

How to fill out Request for De-identified Data Set

1. Obtain the Request for De-identified Data Set form from the relevant authority or website.
2. Fill in your name and contact information at the top of the form.
3. Specify the purpose of your request in the designated section.
4. Clearly describe the type of de-identified data set you are requesting.
5. Include any relevant project details that justify your need for the data.
6. Check the box indicating your understanding of the data use restrictions and confidentiality agreements.
7. Sign and date the form to validate your request.
8. Submit the completed form as instructed, ensuring you retain a copy for your records.

Who needs Request for De-identified Data Set?

1. Researchers seeking data for studies without the risk of identifying individuals.
2. Healthcare organizations looking to analyze patient data without compromising privacy.
3. Government agencies conducting analyses that require non-identifiable information.
4. Universities and academic institutions for educational and research purposes.
5. Businesses wanting to utilize data trends without exposing personal information.

People Also Ask about

What does it mean to be deidentified?

As discussed below, the Privacy Rule provides two de-identification methods: 1) a formal determination by a qualified expert; or 2) the removal of specified individual identifiers as well as absence of actual knowledge by the covered entity that the remaining information could be used alone or in combination with other

Does FERPA apply to de-identified data?

FERPA (34 CFR §99.31(b)(2)) allows an educational agency or institution, or a party that has received education records or information from education records, such as a State educational authority, to release de-identified student-level data (microdata) from education records for the purpose of educational research by

What is a de-identified dataset?

Data de-identification is a form of dynamic data masking that refers to breaking the link between data and the individual with whom the data is initially associated. Essentially, this requires removing or transforming personal identifiers.

Do I need consent to use de-identified data?

De-identified data may be shared without the consent required by FERPA (34 CFR §99.30) with any party for any purpose, including parents, general public, and researchers (34 CFR §99.31(b)(1)).

Can de-identified data be used without patient consent?

Regardless of the method by which de-identification is achieved, the Privacy Rule does not restrict the use or disclosure of de-identified health information, as it is no longer considered protected health information.

What is the common rule for de-identified data?

Under the Common Rule a dataset is “de-identified” only when no one could “re-identify” the data: not the recipients, nor the data provider, nor anyone else. If the data were “coded,” any “key to the code” must be destroyed to “de-identify” the dataset.

Do you need consent to anonymize data?

It refers to the act of permanently stripping personally identifying information (PII) in such a way that an identification link can not be re-established. This means that this type of data is not subject to consent requirements because it does not identify individuals.

For pdfFiller’s FAQs

What is Request for De-identified Data Set?

A Request for De-identified Data Set is a formal proposal submitted to access data that has been stripped of personal identifiers to protect individual privacy while allowing for analysis and research.

Who is required to file Request for De-identified Data Set?

Researchers, organizations, or entities that wish to access de-identified data for analysis, research, or reporting purposes are required to file a Request for De-identified Data Set.

How to fill out Request for De-identified Data Set?

To fill out a Request for De-identified Data Set, one must provide necessary details such as the purpose of data usage, specific data elements requested, and adherence to data governance and ethical standards.

What is the purpose of Request for De-identified Data Set?

The purpose of the Request for De-identified Data Set is to facilitate research and analysis using data that does not compromise individual privacy, thereby supporting public health, education, and other fields.

What information must be reported on Request for De-identified Data Set?

The Request for De-identified Data Set must report information including the requester's details, purpose of data usage, specific data elements requested, and assurance of compliance with relevant privacy regulations.