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  • Forms and templates

    Requesting research data and research data sharing agreements

    To obtain data from Allina Health for research purposes complete the form below. To determine the need for, initiate, and execute a data sharing agreement, please contact Allina Clinical Research Informatics and Analytics (CRIA) researchanalytics@allina.com

    Form

    Instructions

    Research Data Request  

    This form is to be submitted to CRIA researchanalytics@allina.com

    HIPAA / research privacy forms

    Form

    Instructions

    Decedent Research Attestation

    This form must be submitted to Health Information Management (HIM) when accessing Protected Health Information (PHI) for purposes of research when the research is solely on the PHI of decedents without a waiver from the IRB.

    Preparatory to Research Attestation

    This form must be submitted to Health Information Management (HIM) when accessing to Protected Health Information (PHI) for purposes preparatory to research without a waiver from the IRB.