Get Oshpd Ab2876 Data Request Application Checklist - Oshpd Ca

This guide provides a comprehensive and user-friendly overview of how to successfully complete the OSHPD AB2876 Data Request Application Checklist online. By following these steps, users will be well-equipped to ensure that their requests are submitted accurately and efficiently.

Follow the steps to fill out the OSHPD AB2876 Data Request Application Checklist.

1. Press the ‘Get Form’ button to obtain the form and open it for editing.
2. Before proceeding, confirm your eligibility to receive data. This applies to California-licensed hospitals and local health officers/departments.
3. Review the relevant datasets and variables to determine if they meet your needs. You may need to reference Model Data Set documentation specific to your request type.
4. Complete the identification and eligibility section. Ensure that your contact information and your institution's details are clearly filled out.
5. Indicate the purpose for which the data is being requested. Provide detailed descriptions of how the data will be utilized for healthcare operations or public health purposes.
6. If applicable, specify whether an outside contractor will be used and provide their details. A signed Business Associate Agreement is required in this case.
7. Select the years and datasets you wish to request, specifying whether you need statewide data or a subset by specific criteria, such as county or ZIP code.
8. Choose the format in which you prefer to receive the Model Data Set and any custom datasets. Clearly state any geographic details if applicable.
9. Outline any products developed from the data, detailing how you will manage small cell sizes to protect individual identities.
10. Confirm that you have provided adequate information regarding the security measures that will be in place for data handling.
11. Review your completed application package for accuracy. Submit the unsigned preliminary Request Package for OSHPD review.
12. When approved, sign the Request Package as necessary and submit it to OSHPD. Include any required documents such as the IRS 501(c)(3) certificate if applicable.
13. After OSHPD processes your request, respond to any payment and shipping inquiries as directed.
14. Once the data release is approved, arrange for data delivery based on the options provided.

Start completing your OSHPD AB2876 Data Request Application Checklist online today.