In consideration of my request to be granted access to (name of data file(s))
______________________, I ________________________________ (please print)
am aware that I can be held legally liable for any harm incurred by individuals
or establishments who have provided or are described in the information contained
in the above work files to which I will have access, that is caused by my
disclosure of data. Furthermore, I agree:
To make no copies of any files or portions of files to which I am granted
access except those authorized by NCHS Research Data Center staff.
To return to NCHS staff all NCHS restricted materials with which I may be
provided during the conduct of my research at NCHS and other materials as
Not to use any technique in an attempt to learn the identity of any person,
establishment, or sampling unit not identified on the restricted access data
To hold in strictest confidence the identification of any establishment or
individual that may be inadvertently revealed in any documents or discussion,
or analysis. Such inadvertent identification revealed in my analysis will
be immediately brought to the attention of RDC and ASPE staff.
Not to remove any printouts, electronic files, documents, or media until
they have been scanned for disclosure risk by authorized NCHS staff.
Not to remove from NCHS any written notes pertaining to the identification
of any establishment, individual, or geographic area that may be revealed
in the conduct of my research at NCHS.
To the inspection of any material I may bring to or remove from the NCHS
Research Data Center.
To submit to NCHS RDC staff for disclosure limitation review any papers or
reports submitted for publication.
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Human Services Policy
Assistant Secretary for Planning and Evaluation
U.S. Department of Health and Human Services
Last modified on 09/07/01