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Autorización o consentimiento del estudiante atleta para la divulgación de información de salud protegida a la Asociación Atlética Colegial Nacional para el Monitoreo e Investigación de Lesiones o Enfermedades Deportivas - Student-Athlete Authorization or Consent for Disclosure of Protected Health Information to the National Collegiate Athletic Association for Monitoring and Research of Sports Injuries or Illnesses

State:
Multi-State
Control #:
US-01719BG
Format:
Word
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Description

The NCAA Injury Surveillance System (ISS), an ongoing surveillance database maintained by the NCAA. The ISS provides NCAA committees, athletic conferences and individual schools and NCAA-approved researchers with injury, relevant illness and participation information that does not identify individual athletes or schools. The data provide the Association and other groups with an information resource upon which to base and evaluate the effectiveness of health and safety rules and policy, and to study other sports medicine questions. This letter is meant to satisfy requirements of the Health Insurance Portability and Accountability Act (HIPAA).

Para su conveniencia, debajo del texto en español le brindamos la versión completa de este formulario en inglés. For your convenience, the complete English version of this form is attached below the Spanish version.
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How to fill out Autorización O Consentimiento Del Estudiante Atleta Para La Divulgación De Información De Salud Protegida A La Asociación Atlética Colegial Nacional Para El Monitoreo E Investigación De Lesiones O Enfermedades Deportivas?

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Autorización o consentimiento del estudiante atleta para la divulgación de información de salud protegida a la Asociación Atlética Colegial Nacional para el Monitoreo e Investigación de Lesiones o Enfermedades Deportivas