HIPAA Waiver of Authorization
"Waiver of Authorization for Use and/or Disclosure of Protected Health Information (PHI)" for Research form.
This form is applicable when research (study) consent is waived under the IRB regulations (e.g., certain Expedited Review studies, Chart Review studies, etc.). The IRB will review your responses to the nine questions on this form to determine if Waiver of Authorization is justifiable. Note: this form does not affect studies that are IRB approved prior to 4/14/03.