Form DCF-4200 Data Use Agreement - Connecticut

Form DCF-4200 Data Use Agreement - Connecticut

What Is Form DCF-4200?

This is a legal form that was released by the Connecticut State Department of Children and Families - a government authority operating within Connecticut. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form DCF-4200?
A: Form DCF-4200 is a Data Use Agreement used in Connecticut.

Q: What is the purpose of Form DCF-4200?
A: The purpose of Form DCF-4200 is to establish guidelines for the use and sharing of data collected by the Connecticut Department of Children and Families (DCF).

Q: Who needs to fill out Form DCF-4200?
A: Form DCF-4200 needs to be filled out by individuals or organizations who are requesting access to DCF data.

Q: What information is required on Form DCF-4200?
A: Form DCF-4200 requires information such as the purpose of data use, the data elements requested, and the safeguards that will be put in place to protect the data.

Q: What are the responsibilities of the data recipient?
A: The data recipient is responsible for complying with the terms and conditions outlined in Form DCF-4200, including maintaining data confidentiality and using the data for authorized purposes only.

Q: Is there a fee for accessing DCF data?
A: There may be a fee associated with accessing DCF data, depending on the type and extent of data requested. The fee schedule can be found in Form DCF-4200.

Q: What is the duration of the Data Use Agreement?
A: The duration of the Data Use Agreement is typically one year, but it can be extended upon mutual agreement between the parties.

Q: Can the Data Use Agreement be terminated?
A: Yes, the Data Use Agreement can be terminated by either party with written notice.

Q: What happens if there is a breach of the Data Use Agreement?
A: In case of a breach, the Connecticut Department of Children and Families may take appropriate action, including legal action, to address the breach and protect the data.

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Form Details:

  • Released on December 1, 2014;
  • The latest edition provided by the Connecticut State Department of Children and Families;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a printable version of Form DCF-4200 by clicking the link below or browse more documents and templates provided by the Connecticut State Department of Children and Families.

Download Form DCF-4200 Data Use Agreement - Connecticut

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