Clinical Trial Data Use Agreement

1. Parties

This Data Use Agreement ("Agreement") is entered into by and between

• Provider:
• Recipient:

individually referred to as a "Party" and collectively as the "Parties".

2. Purpose

3. Data Description

4. Terms of Data Use

5. Confidentiality

6. Publication and Reporting

7. Data Security

8. Term and Termination

9. Miscellaneous

Provider Representative:

Name: ________________________________

Title: ________________________________

Date: ________________________________

Recipient Representative:

Name: ________________________________

Title: ________________________________

Date: ________________________________