Request for Use of Data With Identifiers and Statement of Assurances - Washington, D.C.

Request for Use of Data With Identifiers and Statement of Assurances - Washington, D.C.

Request for Use of Data With Identifiers and Statement of Assurances is a legal document that was released by the Washington DC Department of Health - a government authority operating within Washington, D.C..

FAQ

Q: What is the Request for Use of Data With Identifiers and Statement of Assurances?
A: The Request for Use of Data With Identifiers and Statement of Assurances is a document used in Washington, D.C. to request access to data containing personal identifiers and provide assurances regarding its use.

Q: What is the purpose of this document?
A: The purpose of this document is to formally request permission to use data containing personal identifiers and to provide assurances that the data will be handled securely and used only for authorized purposes.

Q: Who uses this document?
A: This document is used by individuals, organizations, or entities in Washington, D.C. that need access to data containing personal identifiers for research, analysis, or other approved purposes.

Q: What are personal identifiers?
A: Personal identifiers are data elements such as names, addresses, social security numbers, or any other information that can be used to identify an individual.

Q: What assurances are required to be provided with this document?
A: The document requires the requester to provide assurances that they will handle the data securely, protect the privacy of individuals, and use the data only for authorized purposes.

Q: Is there a specific process for submitting this document?
A: Yes, there is a specific process outlined by the Washington, D.C. government for submitting this document. It typically involves completing the form, providing supporting documentation, and following any additional instructions.

Q: What happens after this document is submitted?
A: After the document is submitted, it will be reviewed by the appropriate authority in Washington, D.C. If approved, the requester may be granted access to the requested data with personal identifiers.

Q: Are there any penalties for misuse of the data?
A: Yes, there may be penalties for misuse of the data. It is important to adhere to the assurances provided in the document and use the data only for authorized purposes.

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Form Details:

  • Released on February 16, 2012;
  • The latest edition currently provided by the Washington DC Department of Health;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Washington DC Department of Health.

Download Request for Use of Data With Identifiers and Statement of Assurances - Washington, D.C.

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