| Document Date: 2013-11-20 21:35:48
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Company INSERT NAME OF CORPORATION / / Country Canada / / Facility Shared Information The Hospital / Guelph General Hospital / The Hospital / / Organization Research Ethics Board / Guelph General Hospital / Hospital’s Research Ethics Board / / / Position health information custodian / researcher / internal researcher / Shared Information The Researcher / Enurement The Researcher / / ProvinceOrState Ontario / /
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NOTE TO USER: This Sample Information Sharing Agreement is intended to be used for retrospective research. A customized version of this Sample Information Sharing Agreement could be used when GGH discloses personal healt