MCHP Annual Accreditation Verification

This annual update form is used to confirm your current information regarding the MCHP orientation and accreditation. The initial accreditation session must be done in person prior to starting any research at MCHP.

Please complete and submit the following information:

Name:
Address:
Email:
Phone:
Fax:
I have reviewed the MCHP Accreditation Update online. The original accreditation session slides are also available on the MCHP website.
I understand the need for privacy and confidentiality when working with the Manitoba Population Research Data Repository.
I acknowledge the requirement to submit a MCHP Project Feasibility and Data Access Quote Request form prior to submitting any other approvals or grant applications. The request will be submitted at least 10 working days prior to the date a response is required. I understand that if there are outstanding questions that the time to receive and estimate may be extended beyond 10 working days.
I understand that every project requires approvals from at least the Manitoba Health Information Privacy Committee (HIPC) and UofM Health Research Ethics Board (HREB). A Researcher Agreement needs to be signed prior to the start of each project. Additional approvals may also be required depending on the data sets being used in the project.
I have completed the UofM Pledge of Confidentiality. This was done, or confirmed, as part of the initial MCHP Accreditation session and does not need to be re-done at this time. Privacy and Confidentiality material for the UofM can be reviewed through the UofM Access & Privacy Coordinator's Office.
I understand that any new publication or presentation of information must be submitted for review to HIPC / MHSAL and other data providers, if applicable, prior to public release. For more information regarding publication and presentation requirements, please read section 1. Output Notifications and Approval Process, under the Guidelines and Requirements heading in the web page Step 10 - Data Use and Output Guidelines.
Comments:
MCHP Associated Principal Investigators:
I received and reviewed the list of projects with funding sources, and published papers, that were sent as part of the annual update notification email. This confirms that the information on active projects, available funding, and published papers is accurate.
Student Principal Investigator (MSc., PhD, Resident): I have graduated in the past year.
Additional Publications and Project Changes **:
** Only papers using the MCHP data repository that were not listed in the reminder email need to be included here. Please include the HIPC number for the project (sample).

If you have any questions please contact:

Repository Access Coordinator
Manitoba Centre for Health Policy
Dept of Community Health Sciences
Max Rady College of Medicine
Rady Faculty of Health Sciences
University of Manitoba
408 Brodie Building, 727 McDermot Avenue
Winnipeg, Manitoba R3E 3P5

email: mchp_access@cpe.umanitoba.ca

Tel: 204-975-7770 or 204-789-3429
Fax: 204-789-3910

The information provided above will be used to identify individuals that have reviewed the MCHP accreditation material. Contact information will be maintained and used for contacting you regarding project approvals, and use of the MCHP Repository. It is collected in accordance with the Manitoba Freedom of Information and Protection of Privacy Act (FIPPA). If you have any questions about the collection of data or the Act, please contact the FIPPA coordinator's office.