CLINICAL CARE

PATIENT FORMS

Forms containing patient information will NOT be placed on this Web Site. These forms are provided by the Clinical Center, Medical Records Office and should only be placed in the patient's official Medical Record file. If you have created a form to store patient information, you may be violating the Privacy Act. Please seek guidance from the Clinical Center, Medical Records Office, 496-0827.

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CODE.SOFTWARE CODE - FORM TITLE - REVISION DATE

• HS596.FP3 - HHS-596 - DHHS Protection of Human Subjects Assurance/Certification/Declaration - 1/82
• HUSBREV.FP3 - Request for Review of Research Activity Involving Human Subjects - None
• HUSBSLPR.FP3 - Request for Single Project Assurance Negotiation - None
• NH2558.FP3 - OMS Medical Evaluation of Functional Activities - 4/97
• NSWOMCLN.FP3 - NINDS Tracking of Women & Minorities in Clinical Studies - 3/8/96
• OF310.FP3 - OF-310 - Protection of Human Subjects - Assurance Identification/Certification/Declaration - 9/92