Download Letter of Permission for Use of Data or Samples

Letter of Permission for Use of Data or Samples
INSTRUCTIONS: THIS DOCUMENT IS TO BE USED AS EXAMPLE ONLY. PLEASE EDIT THE EXAMPLE BELOW, OR CREATE A
NEW DOCUMENT. PLEASE REMOVE ALL TEXT IN THIS SECTION FROM YOUR DOCUMENT BEFORE PRINTING/SIGNATURE.
When is a letter of permission required? A letter of permission is typically required to use data/samples owned by another
individual.
Who writes the letter? Letters of permission are typically written and signed by the individual who owns the data or who
otherwise has the authority to share the data. LETTERS SHOULD BE PRINTED ON OWNER’S LETTERHEAD STATIONARY.
What information should the letter include? The content of a typical letter is summarized below. However, not all
information is required for all projects, and some projects may require additional information. If you have questions about
the content of this letter, please contact Rebecca Novak at [email protected] or Dr. Laura Mitchell at
[email protected]
MEMORANDUM
DATE:
Today’s Date
TO:
Anne Dougherty, MD
Chair, UT Committee for the Protection of Human Subjects
FROM:
Data owner’s name, title, and contact information
SIGNATURE:
RE:
Permission for Use of Data/Samples
The data owner should:

indicate that s/he gives the student permission to analyze the data (or samples) collected
during the project, “original project name,” expressly for the CE/thesis/dissertation project
(select the appropriate project type) titled, “student’s project name.”

explain whether there are identifying variables in the parent data set, and if so, whether or not
the student will be given access to identifiers.

indicate whether data were collected with the approval of an Institutional Review Board (IRB).
For data collected within UTHSC, list the original study’s CPHS approval number (HSC-SPH-______). For data collected outside of UTHSC, provide a copy of the study’s IRB approval letter.

indicate whether the student is part of (or will be added to) an active UT-CPHS protocol, and if
so, provide appropriate documentation (e.g. a copy of the CPHS letter approving the personnel
changes). For more information about adding a student to a UT CPHS protocol, please see the
Research Compliance Guide at:
https://sph.uth.edu/content/uploads/2014/08/RESEARCH-COMPLIANCE_2014.pdf
Fall 2014