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Get Hfemsd Case Level Data Request Form - Colorado.gov - Colorado
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How to use or fill out the HFEMSD Case Level Data Request Form - Colorado.gov - Colorado online
Filling out the HFEMSD Case Level Data Request Form is a crucial step for individuals seeking confidential EMS or trauma data from the Colorado Department of Public Health and Environment. This guide will provide clear and user-friendly instructions on how to complete the form accurately and efficiently.
Follow the steps to successfully complete the request form.
- Press the ‘Get Form’ button to access and open the form for editing.
- Complete the Requestor Information Form located on page 1. Provide your name, agency or institution, address, email, and phone number. Ensure that all required fields are accurately filled.
- Move to the Data Request Form on page 2. Indicate which dataset you are requesting by selecting either the Emergency Medical Services (EMS) or Trauma Registry (TR) option.
- Provide a brief summary of the information you are requesting. If possible, list the variable names to specify what data is needed.
- Describe how the data will be used, offering a clear understanding of its intended application.
- Fill out the desired completion date and select the preferred data format (printed/hard copy, MS Access, Excel, SAS, or other).
- Choose your preferred method of delivery: mail (on CD/DVD), email, fax, or pickup (on CD/DVD, portable media).
- Prepare the Study Summary/Protocol/Proposal to accompany your request. This document should detail the project’s purpose, public health importance, specific data items requested, and justification for each variable.
- Review and complete the Data Security, Use and Confidentiality Agreement on page 3. Initial next to each item to confirm your understanding and agreement.
- Obtain the Requestor Supervisor/Advisor Letter using the provided template on page 4. Ensure it is completed on official letterhead and includes required information.
- Once all sections are completed, save your changes. You can download, print, or share the form as needed.
Complete your HFEMSD Case Level Data Request Form online today to ensure your information needs are met promptly.
No. COVID-19 is an immediately reportable condition in Colorado. That means that the lab that processed your test or the health care provider who ordered it must report the results to public health.
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