Document jy4b0gK15VBwp7kdqQdewgNO2

MISSOURI DEPARTMENT OF P.O. Box 570, Jefferson City. MO 65102-0570 314-751-6400 FAX 314-751-6010 March 23,1995 Mel Carnahan Governor Coleen Kivlahan, M.D., M.S.P.H. Director Hasmukh C. Shah, Ph.D., DABT Manager, Vinyl Chloride Panel Chemical Manufacturers Association 2501 M Street, NW Washington, DC 20037 Dear Doctor Shah: Since you are changing contractors, we will need a new protocol completed for your study. Enclosed is the form for your use. Sincerely, Garland Land Director Division of Health Resources GL/mp R&S151358 Recycled Paper AN EQUAL OPPORTUNlTY/AFFIRMATtvE ACTION EMPLOYER -- Services provided on a nondiscrirnincrtc>ry basis PROTOCOL FOR RESEARCH USING MISSOURI VITAL RECORDS APPROVAL NUMBER Describe purpose of the study: Describe study methodology and intended use of the data: How long will the study last? (Approval number will be valid only for this time period.) Describe confidentiality measures to be taken: Will any agency besides the requesting agency have access to the vital records? No Yes_____ If yes, indicate what agency and attach a separate letter from the agency describing the confidentiality measures which they can assure. Any federal agency must provide legal counsel's opinion on the applicability of the Freedom of Information Law as pertaining to the vital records requested. What disposition will be made of the records following the completion of the study? Principal Investigator's Signature Date Address _________________________ R&S151359 63