Please include the following information

Using the following statement, or in your own words, generally state the data used in this study will be provided by the Clinical Data Warehouse using i2b2 to structure the query for data retrieval.
Write out your i2b2 inclusion/exclusion criteria (or include a detailed data collection sheet) and please include your i2b2 project request number if available. For clarity, you have the option to include a PDF of your ib2 print query report. Please review the how-to "Print Query" article for more instructions.
In the methods section, please list out any Identifying patient information being requested, or attach as a data collection sheet.
1. ADDRESS1
2. ADDRESS2
3. Admit Date
4. City
5. Discharge Date
6. Encounter Number
7. MRN
8. Name
9. Phone
10. State
11. Zip
Indicate if you intend to contact patients using the information provided by the Informatics and Analytics core for study recruitment purposes.
Please make sure to check off the respective county facilities in section 6.1 of your IRB application as well as include a written list of which specific facilities (ex. Olive View, Harbor, etc.).
Indicate if you will or will not require a HIPAA Waiver of Informed Consent. If yes, please include the “Waiver of Informed Consent” language.
Include a plan for data storage, transfer, and management. Please indicate that all data files will be encrypted, password protected and will only be accessed/reside behind DHS firewalls. Data will only be released to individuals named and approved for viewing identifiable data as named in your IRB. All provisioned datasets will be destroyed upon completion of the research study. Please indicate that the Informatics and Analytics Core will receive any incoming data and deliver the requested data via one of the two following methods.
1. DHS Shared Drive
2. /wiki/spaces/FAQS/pages/700481643

Once you have received IRB approval and categorization, you are ready to submit a data request to the DHS Informatics and Analytics Core.