FINGER LAKES DATA USE AGREEMENT

[Research]

 

To receive Finger Lakes Regional Perinatal Data System data you must:

Review the following conditions for data release, sign this form and fax it to the Finger Lakes Regional Perinatal Data System (585.276.2333 prior to receiving the requested database.

 

  1. You have requested data from the Finger Lakes Regional Perinatal Data System.  The data you have requested is collected from all birthing hospitals in the Finger Lakes New York Region.  It is critical that this information be released carefully and with all assurances of complete confidentiality.

 

  1. This information may not be re-released by you under any circumstances without the prior approval of the Finger Lakes Regional Perinatal Data System. This includes distribution of the data file or a subset of the data file, publication or public presentation that includes this data by any person other than the person signing this agreement.

 

  1. This information has been released solely for the purpose of conducting research.

 

You are not authorized to use this information for any use other than the approved study.

 

  1. If you are not familiar with the Perinatal Data System (PDS), it is strongly recommended that you involve a PDS expert to assist you with the interpretation of the data.

 

  1. When faxing this signed data release form, please include a statement specifying the data elements and years of data requested and any other specific criteria important to your study.

 

  1. You may apply for permission to receive PDS data prior to receiving IRB approval but you must submit a signed IRB approval for your work prior to the actual release of data. 

 

  1. This data is for your exclusive use only. You must maintain these files in a password protected file, accessible to you only. Failure to comply with this agreement will precluded your access to additional PDS data and will be reported to authorities at your institution.

 

The data file can be requested in several formats such as dbaseIV, Excell, Access etc.  If you have any questions about any of the above, or have any questions about the database, please contact Joseph Duckett (Joseph_Duckett@urmc.rochester.edu).

 

 

 

 

     _________________  __________                    _________________  __________

       Ann Dozier, Ph.D.                  Date                            Researcher            Date

 

 

University of Rochester

Division of Public Health Practice · Department of Community and Preventive Medicine

601 Elmwood Avenue, Box 278969 · Rochester, New York 14642 · 585-758-7840 (voice) · 585-424-4485 (FAX)