Defense Health Agency Data Sharing Agreement Application

Submit a Data Sharing Agreement Application in order to request a Data Sharing Agreement for systems managed by the Defense Health Agency. The DSAA is submitted for all research requests and TRICARE contractors who follow the TRICARE Systems Manual.

• Request a DSAA, Prerequisite Checklist, DSA Renewal, or DSAA Modification by emailing dha.ncr.pcl.mbx.data-sharing@health.mil.
• Submit completed templates to dha.ncr.pcl.mbx.data-sharing@health.mil.

Prerequisite Checklist

Submit a Prerequisite Checklist for a compliance review of a DSA submission for systems management by the DHA. The PRC is submitted for any non-research request.

Data Request Templates

Data Request Templates are provided to specify the data a project seeks for the project specified in the DSAA specific use. Attach a DRT for each system listed in the “Source and Type of Data” section of the DSAA. Choose from the DRTs listed below. Each DRT includes instructions and a sample.

• DRT Quick Reference Guide
• Extraction DRT (MDR): Email the DSA general mailbox for the most current copy of this DRT.
• General Extractions DRT (for all other DHA Systems)
• Login Access DRT (all DHA Systems)

Note: The DRT is required unless otherwise determined by the DHA PCLO.

De-Identification Plan Template

Completion of a De-Identification Plan is required to support the "Data De-identification, publishing, and reporting" section of a DSAA when de-identifying PHI in accordance with HIPAA regulations. The plan should show how MHS sensitive data elements will be de-identified, as well as how the HIPAA 18 identifiers will be handled.

DSA Change and Modification Templates

• Change of Government Sponsor — Submit a Change of Government Sponsor to document a new Sponsor for the DSA.
• Change of Applicant/Recipient — Submit a Change of Applicant/Recipient to document a new Applicant/Recipient for the DSA.
• Modification Request — Submit a Modification Request to document any changes to the information provided in the DSAA of an existing DSA. If the DSA expires within 30 days, then submit a Renewal Request in lieu of Modification Request.
• Extension Request — Submit an Extension Request to request a 30 day extension of an existing DSA that will expire and a renewal is not needed.
• Renewal Request — Submit a Renewal Request to renew an existing DSA.
• Certification of Data Disposition — Submit a CDD within 30 days of the expiration of a DSA or the end of the project, whichever comes first, to certify that the data used in connection with the DSA was appropriately disposed.