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Application for Certificate of Confidentiality

SOP #:  RPS-10

Next Review Date:  06/2015

Version #:  1.0

Interval Period:  Biennual

Approved Version 1.0:  ___   Date:  06/2013

Policy Reference: 

Purpose: Provide additional protection for sensitive information obtained during the conduct of biomedical, behavioral or clinical research.
Step 1: Collect and prepare necessary documents

The application for a Certificate of Confidentiality is Institute specific. The general intramural instructions can be found at .

  • Applicants should read NIH's background information and instructions on Certificates of Confidentiality, which are available at See also Frequently Asked Questions .
  • The application requires an IRB-approved protocol. 
    • Prepare the protocol and consent (initial IRB application or amendment) with the required wording
    • Obtain "conditional" IRB approval with an IRB (iRIS) approval memo.
    • Obtain the PI and Scientific Director’s signature on the cover letter of the application.
    • Submit the application with the IRB approval memo, protocol and consent to the IC Certificate Coordinator (
    • Upon approval of the application, submit approval in iRIS. 


Resources for additional information: 


Current IC Certificate Coordinator for NCI Intramural 

Samson Adepoju
National Cancer Institute
9609 Medical Center Drive, Room 3W262
MSC 9711
Rockville, MD 20850
Phone: 240-276-5660
Fax: 240-276-7912

Last updated by Richman, Michele (NIH/NCI) [C] on Oct 31, 2014