Registration and Data Agreement Form

Whether your interest is to start or join a teleECHO clinic, or simply to learn more about Project ECHO, please read our privacy statement below and use this form to give Highland Hospice permission to store your data within the ECHO Project.

Please read the Project ECHO Privacy Notice below and confirm your agreement as appropriate.

Project ECHO Privacy Notice

Data protection and personal data
The collection of information from individuals whether online or manually is likely to be personal data as defined by relevant UK legislation. If you wish to participate in any way in Project ECHO, clinic attendance and speciality information is required by UNMHSC in the United States.

Information about Project ECHO
Project ECHO has been developed and is owned by the Regents of the University of New Mexico (UNM), the rights to which have been assigned or licensed to the University of New Mexico Health Sciences Centre (UNMHSC). Project ECHO communities track their growth and activities within the iECHO database.

Where will your data be stored?
Your full data will be stored securely by Highland Hospice (see the Highland Hospice Privacy Notice here).  Personal identifiable data is pseudonymised before storing separately in the iECHO database.  Access to your data is strictly limited and password protected.

How will your data be used in IECHO?
Your data is combined and measured in various ways for analysis. It may be used for reporting to funding and governmental entities, for research related to the movement, for data quality assurance activities and in decision making related to new initiatives. Highland Hospice will not use your data for any other purposes.

Accuracy, access and retention
Highland Hospice have a responsibility for ensuring data stored is accurate. Upon request, your HUB can provide details of your stored personal data. Highland Hospice have a Privacy Notice and your personal data can be removed at your request. This may take up to one month to clear from backups.