Clinical Research Contract Administration Office

Confidentiality Agreement Request Intake Form

Help Text: Use this form for CDA submissions in anticipation of human subject's research only. Otherwise, submit your request via the appropriate portal (SIFTER or SOPHIA)

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Help Text: This field is to help determine urgency and when the anticipated disclosure is set to take place.

Sensitive Data & Data Exchange

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Help Text: Safety information, protocol information, two-way development, Information Protection (IP) surrounding products, expertise, or disease area, etc.

Help Text: CHOP does not share patient data or materials under a CDA. If you intend to share patient date or materials, please contact CRCA at ClinicalResearchContracts@chop.edu

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Counterparty’s Contact Information

Contract template file

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Please include any additional information you would like the contract negotiator to be aware of.


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