CDA/NDA Request Form

"*" indicates required fields

The purpose of this form is for a UTSI PI to request a confidentiality agreement (CDA) to facilitate technical discussions and the sharing of confidential information between UTSI and an outside entity. The Office of Proposals and Contracts will use the information provided to begin the review and negotiation process.

No research or work should be conducted under a CDA. If you need to share materials or samples in addition to confidential information or perform evaluations or research with the outside entity, please contact our office directly or include detailed information herein regarding the additional requests.

DIRECTIONS: This form should be completed by the UTSI PI requesting the CDA.

UTSI Participant

OUTSIDE ENTITY INFORMATION

CONFIDENTIAL INFORMATION TO BE DISCLOSED

Does the information being disclosed include UT confidential information?
Was the information developed from an internally- or externally funded UTSI research project? (explanation required):
Is the information subject to any third-party rights or reporting obligations resulting from any ofthe following (select all that apply – explanation(s) required):

DESCRIPTION OF THE PURPOSE AND USE OF CONFIDENTIAL DISCLOSURE

COMPLIANCE

(select all that apply – detailed description(s) required):
Conflict of Interest:
Export Controlled Information:

EXTERNAL PARTIES/COLLABORATORS

Will you need to provide any of the OUTSIDE ENTITY’s confidential information to any outside sponsors,collaborators, subcontractors, or other non-UT employees, including unpaid UT students?
By submitting this form, you agree that all information is correct. The form will be submitted directly to UTSI Office of Proposals and Contracts.*
This field is for validation purposes and should be left unchanged.