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Suggested Consent Language: Certificate of Confidentiality

Research Integrity

If this study has a Certificate of Confidentiality and no information about the subject’s participation in the research and/or will be place in the in Medical Record, use the verbiage in the link directly below:

Certificate of Confidentiality No Alias No Information in Medical Record

If this study has a Certificate of Confidentiality and information about the subject’s participation in the research and/or research results will be place in the in Medical Record, use the verbiage in the link directly below:

Certificate of Confidentiality No Alias Information in Medical Record

If this study has a Certificate of Confidentiality and an “alias” medical record will be created specifically for the need to order medical tests via EPIC, use the verbiage in the link directly below:

Certificate of Confidentiality and Alias Medical Record

Note: Alias Medical Record means that an appropriate de-identification process is required. The PI is responsible for consulting with the Epic Research Team to determine the appropriate process for de-identification and study designation in the SPARC Request system as well as the legal medical record. For more information please see Research Documentation in the Legal Medial Record (PDF).