The NCAA Injury Surveillance System (ISS), an ongoing surveillance database maintained by the NCAA. The ISS provides NCAA committees, athletic conferences and individual schools and NCAA-approved researchers with injury, relevant illness and participation information that does not identify individual athletes or schools. The data provide the Association and other groups with an information resource upon which to base and evaluate the effectiveness of health and safety rules and policy, and to study other sports medicine questions. This letter is meant to satisfy requirements of the Health Insurance Portability and Accountability Act (HIPAA).
New Hampshire Student-Athlete Authorization or Consent for Disclosure of Protected Health Information to the National Collegiate Athletic Association (NCAA) for Monitoring and Research of Sports Injuries or Illnesses is a formal document required by the NCAA to obtain consent from student-athletes in order to disclose their protected health information (PHI) for the purpose of monitoring and researching sports-related injuries or illnesses. This consent allows the NCAA to collect, analyze, and utilize data in an effort to improve athlete safety, develop prevention strategies, and enhance the overall well-being of student-athletes. The New Hampshire Student-Athlete Authorization or Consent for Disclosure of Protected Health Information to the NCAA for Monitoring and Research of Sports Injuries or Illnesses form typically includes the following key components: 1. Personal Information: This section requires the student-athlete to provide their name, contact information, date of birth, and the name of their educational institution. 2. Consent to Disclose PHI: This section outlines the student-athlete's authorization or consent to disclose their protected health information to the NCAA. It may include a specific timeframe during which the consent is valid. 3. Purpose of Disclosure: This part explains that the disclosed PHI will be used for monitoring and research purposes related to sports injuries or illnesses. It may mention that the information will be disidentified or anonymized to protect the athlete's privacy. 4. Nature of Disclosure: This section clarifies the type of information that may be disclosed, such as medical records, diagnostic reports, treatment plans, or any other relevant health data deemed necessary by the NCAA. 5. Use and Confidentiality: This part addresses how the disclosed information will be used, emphasizing that it will be handled in compliance with applicable privacy laws and regulations. The student-athlete's PHI will be kept confidentially, and only authorized personnel involved in monitoring and research initiatives will have access to it. 6. Revoking Consent: This section outlines the process for revoking consent, including the specific steps the student-athlete needs to follow to withdraw authorization if they wish to do so. 7. Signature and Date: The form must be signed and dated by the student-athlete to acknowledge their understanding and voluntary participation in the authorization or consent process. It's worth noting that the specific format or name of this consent may vary between educational institutions or athletic programs within New Hampshire. However, the overall purpose and content of the form should align with NCAA guidelines and state regulations to ensure the protection of student-athletes' health information while allowing for valuable research and injury prevention efforts.
