Wyoming Department of Health Institutional Review Board HIPAA 2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by indicating your sources of Protected Health Information (PHI) in the first section. List all applicable sources such as hospital records, billing records, and any other relevant data.
  3. In the second section, identify all WDH affiliated individuals requesting access to PHI. Fill in their names, degrees, divisions, and roles in the project.
  4. Next, list any Non-WDH affiliated individuals or institutions that may receive PHI. Ensure you check the status of the Business Associate Agreement for each entity.
  5. Indicate when PHI will no longer be used or disclosed by selecting one of the provided options or specifying a date.
  6. Finally, determine if individual authorization is required for using or disclosing PHI. If a waiver is requested, complete the necessary sections regarding disclosures.

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The HIPAA Privacy Rule explicitly permits a covered entity to reasonably rely on a researchers documentation of an Institutional Review Board (IRB) or Privacy Board waiver of authorization pursuant to 45 CFR 164.512(i) that the information requested is the minimum necessary for the research purpose.
The IRB is concerned with protecting the welfare, rights, and privacy of human subjects. The IRB has the authority to approve, exempt, disapprove, monitor, and require modifications in all research activities that fall within its jurisdiction as specified by both the federal regulations and institutional policy.
An IRB is a committee charged with protecting the rights and welfare of human subjects in research. An IRB reviews and monitors research plans, including protocols and instruments, for risks to human participants.

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