For data-only studies in which HIPAA requirements are not waived by an IRB, participants sign a HIPAA release form to allow their protected health information to be used. This example HIPAA release form could serve as a template for others. Click here to download.
Pace WD, Staton EW, Holcomb S. Practice-based research network studies in the age of HIPAA. Annals of Family Medicine. 2005;3(Suppl 1):S38-S45.  http://www.annfammed.org/cgi/data/3/suppl_1/s38/DC1/1