Application form B

If you have questions regarding data delivery or the application form, please contact the Data Delivery Unit at the Cancer Registry of Norway.

http://kreftregisteret.no/no/Generelt/Datautlevering/

1. Contact details
1.1 Date

Måned Dag År
1.2 Applicant's name *
1.3 Position/degree
1.4 Applicant's institution *
1.5 Address
1.6 Phone number *
1.7 E-mail *
1.8 Responsible institution *
1.9 Invoice address
Please see our billing procedures
1.10 Invoice comment
If nothing else is given, invoice will be marked with the applicant's name

2. Project details
2.1 Project title *
2.2 Project start and project end *
2.3 When will the data be deleted/anonymized? *

Måned Dag År
2.4 Information about project financing
2.5 Will the data be transfered to countries outside the EEC? *

Yes No
2.6 Will data be transfered to international organisations? *

Yes No
2.5 Further information about the project
You may disregard this section if other attached documentation contain this information.
Project description

If "Yes" is answered on any of the questions below, relevant documentation should be attached. *

	Yes	No
4.1 Is approval from other data controller institutions required? *
4.2 Does the project require consent from the participants? **
4.3 Is exemption from the duty of confidentiality applied for? ***
4.4 Does the project have an ethical approval from the Regional Committees for Medical and Health Research Ethics (REK)? ***
4.5 Is a Data Protection Impact Assesment (DPIA) conducted? ****

*	Contact details can be forwarded when available.
**	Copy of consent form/information letter must be attached.
***	Copy of application and approval must be attached.
****	If yes, attach DPIA. If the project has a concession from The Norwegian Data Protection Authority, recommendation from a Data Protection Officer or approval from REK dated before the implementation of GDPR, there is no need to do a DPIA. Relevant documentation must be attached.

4.6.1 Does the project have a concession from The Norwegian Data Protection Authority, recommendation from a Data Protection Officer or an approval from REK dated before the implementation of GDPR? If "Yes", attach documentation. *

Yes No
4.6.2 If "Yes" in 4.6.1, has there been any changes in the processing of data after the implementation of GDPR?

Yes No
4.6.3 If "Yes" in 4.6.2, describe the changes and the assessments that have been done regarding performing a DPIA.

5. Attachments
5.1 Number of attachments
5.2 Research protocol
5.3 Other attachments than given in item 4
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Avbryt of
5.4 Other relevant information
For questions, contact datautlevering@kreftregisteret.no
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