Provident Hospital of Cook County

Cook County, IL

Official Website: https://cookcountyhealth.org/locations/provident-hospital-of-cook-county/

Forms & Documents

Browse all Provident Hospital of Cook County government forms

1 - 20 of 27 forms

Form Title Topics
ADULT  for Minor Informed Consent with HIPAA Authorization Form
ADULT Informed Consent with HIPPA Authorization Form
Central IRB Guidance
Child Assent Document
Clinical Trial Requirements
Compliance Letter 2021
Computer Sign-On Form
Confidentiality Agreement Form
Consenting Non-English-Speaking Study Participants
Cook County Health HIPAA Authorization for Research
Cook County Health HIPAA Authorization for Research – Spanish
English Template for Short Forms
Guidance for Reopening Research at Cook County Health – June 17, 2020
HIPAA Language Consent Form
Infection Control Screening Compliance Form/Purple Form
IRB Meeting Calendar 2021
Polish Short Form Consent
Recruiting & Advertising for Research Participants
Reliance Agreement Request Form
Remote Consent Guidance

Contact Information & Office Locations

1 contact point

Provident Hospital of Cook County

Address:
500 E. 51st St.
Chicago, IL 60615

Phone numbers:
  • (312) 572-2000

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