Certificate of Disposition (COD)

Purpose of this document

The Certificate of Disposition (COD) form is used to request to close your DUA or to notify CMS of the disposition of specific files on the DUA.

Who uses this document

The Requester or Data Custodian must complete the Certificate of Disposition (COD) to close certain files on the Data Use Agreement (DUA) but leave the DUA and the remainder of its files open or if they wish to close the entire DUA.

Document Version:
10/2022
Format:
Adobe PDF