Office of Sponsored Programs OSP Home About OSP Contact Us Finding Funding Limited Submissions Prepare a Proposal Deadline Policy Preparation Assistance Fact Sheet (pdf) GRAMS F&A Agreement (pdf) Negotiate a Contract How to Request an Agreement Manage an Award Effort Certification Best Practices Resources F&A Distribution Learn More Newsletter Policies Monthly Report (Internal Access) Annual Report (pdf) UNTHSC Division of Research Forms, Templates, and Application Packages HomeOffice of Sponsored ProgramsResearch Non-Disclosure Agreement Request Menu OSP Home About OSP Contact Us Finding Funding Limited Submissions Prepare a Proposal Deadline Policy Preparation Assistance Fact Sheet (pdf) GRAMS F&A Agreement (pdf) Negotiate a Contract How to Request an Agreement Manage an Award Effort Certification Best Practices Resources F&A Distribution Learn More Newsletter Policies Monthly Report (Internal Access) Annual Report (pdf) UNTHSC Division of Research Forms, Templates, and Application Packages Research Non-Disclosure Agreement Request 1. HSC Faculty InformationName* First Last Title* HSC Faculty Department*Choose a DepartmentBIOSTATICS & EPIDEMIOLOGY - 303300CENTER FOR HUMAN ID - 304600CTR F/DIVERSITY & INTN'L PROGS - 300220FAMILY MEDICINE - 300690HEALTH BEHAVIOR & HEALTH SYS - 303500INCEDO - 300580INST TRANSLATIONAL RESEARCH - 304700INTERNAL MEDICINE-GEN - 300700LIBRARY - 300540LIFESTYLE HEATH SCIENCES - 300860MEDICAL EDUCATION - 300760MICROBIOLOGY,IMMUNOLOGY & GENE - 302800PEDIATRICS - 300740PHARMACEUTICAL SCIENCES - 301400PHARMACOLOGY & NEUROSCIENCE - 302700PHARMACOTHERAPY - 301300PHYSICAL THERAPY - 300820PHYSICIAN ASSISTANT STUDIES - 300840PHYSIOLOGY AND ANATOMY - 302600OtherOther Department Phone Number*(###) ###-####Departmental Admin Contact (if applicable) 2. External Party InformationEntity Name* Entity Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Scientific Contact Name* First Last Email Address* Administrative Contact Name* First Last Email Address* Phone Number(###) ###-####3. Agreement TypeIs this a new NDA or an amendment to an existing NDA?* Amendment New Please attach a copy of the original agreement.*Max. file size: 15 MB.4. Subject Matter of the AgreementInstructions: Please describe the subject matter and individual topics you intend to discuss under the NDA. This description should be specific to the topics of your research interest.*5. Purpose of the AgreementWhat outcome are you hoping to facilitate?* Sponsored Research Research Collaboration Fee-for-Service Activity License or IP Agreement 6. NDA TemplateHas the other party provided a template NDA for review?* Yes No Please attach a copy of the template provided.*Max. file size: 15 MB.
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