HIPAA Authorization Research Form [1]
Authorization for Release of Identifiable Health Information for Research
Authorization for Release of Identifiable Health Information for Research
Links:
[1] https://hso.research.uiowa.edu/hipaa-authorization-research-form
[2] https://hso.research.uiowa.edu/sites/hso.research.uiowa.edu/files/forms/HIPAAAuthorizationResearchFormtemplate.pdf