Privacy Act Notice

This statement is provided pursuant to the Privacy Act of 1974 (5 U.S.C. § 552a):
The information requested in this form is authorized to be collected pursuant to 42 C.F.R. Part 93, Public Health Service Policies on Research Misconduct, and sections 301, 401, 402, 405, and 493 of the Public Health Service Act, 42 U.S.C. §§ 241, 281, 282, 284, and 289b. Providing the requested information is voluntary. Further, should you decide to remain anonymous, our ability to assess your concerns could be limited based on our inability to get additional information from you. The principal purpose for which the information will be used is to carry out an assessment of whether your allegation of potential research misconduct appears to fall within the definition of research misconduct; appears to involve PHS-supported biomedical or behavioral research, biomedical or behavioral research training, or activities related to that research or research training; and is sufficiently credible and specific so that potential evidence of research misconduct may be identified. The information you provide will be included in a Privacy Act system of records and can be used and disclosed for the purposes and routine uses described and published in the following System of Records Notice (SORN): 09-25-2023 Privacy Act of 1974; Proposed Exempt New System of Records, HHS/NIH