Submitter*
Enter First and Last Name
Explain Special Circumstances Relative to Urgency*
Explain Special Circumstances Relative to Urgency–Include the Name and Telephone Number of the Requesting Dean/Dept. Head
Confidentiality
When agreement contains confidentiality or non-disclosure provisions that require UConn to keep information confidential, please confirm the presence of the following: “. . . except as may be required by law, including Connecticut General Statutes Chapter 14, the Connecticut Freedom of Information Act.” [This language is NOT added when UConn is required to keep patient PHI confidential.]
Governors’ Executive Orders provision is present
Enter a page number or addendum/exhibit number in space above.
Connecticut Nondiscrimination provision is present
Enter a page number or addendum/exhibit number in space above.
Claims Against the State (C.G.S. Chapter 53) is present
Enter a page number or addendum/exhibit number in space above.
NOTES/COMMENTS
For Comments, include any background or additional information that will assist OGC’s review.