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Institutional Review Board

Health Insurance Portability and Accountability Act (HIPAA)


Data Use Agreement

This template agreement is to be filled-in by the investigator and presented to the IRB of Record as part of the study protocol Submission to the IRB.

The IRB of Record will forward a copy of this agreement to a UPMC representative for UPMC approval. The Honest Broker must be presented with a copy of the fully-executed agreement (to include final approval from UPMC) in order for the Honest Broker to access UPMC data for the purpose of the corresponding research study.

Data Use Agreement (Word)