Get Doh-5132 Instructions. Sparcs Limited And Identifiable Data Request Form Instructions - Health Ny

Filling out the DOH-5132 Instructions form is a crucial step in requesting data for healthcare research and analysis. This guide offers a structured approach to ensure a smooth completion of the SPARCS Limited and Identifiable Data Request Form, catering to users of all experience levels.

Follow the steps to successfully complete the DOH-5132 form online.

1. Use the 'Get Form' button to download the DOH-5132 form and open it in your preferred document editor.
2. At the top of the form, indicate whether you are requesting limited or identifiable data. Consult the SPARCS public website for guidance on what constitutes each type.
3. In the 'Organization and Individual Requesting the Use of Data' section, provide complete details about the Project Director, including name, title, phone number, and email address.
4. List the organization name and address associated with the Project Director. Ensure that the organization name aligns with institutional affiliations.
5. Identify the Contact Person responsible for communication regarding the request. If the Project Director serves this role, leave this section blank.
6. Specify the Type of Requestor to determine applicable costs and potential discounts. Select all relevant categories to ensure accurate processing.
7. Complete the 'Nature of Request' section by providing the Title of Project, stating the Primary Reason/Purpose, Objective, and Benefit clearly.
8. Check applicable boxes under Type of Request to classify the purpose of your study, such as epidemiological, health planning, or research studies.
9. Detail the data requested by specifying the Data Types and Years needed. You may request up to three future years of data.
10. If applicable, include updates on the requested data frequency and any justification for requesting identifiable HIV/AIDS or abortion records.
11. Confirm compliance with protection of human subjects by indicating if Institutional Review Board (IRB) approval has been obtained or submitted.
12. In the 'Confidentiality of Data' section, explain how data security will be maintained and describe storage measures.
13. Gather required signatures from both the Project Director and the Organizational Representative to confirm agreement with terms.
14. Review all sections of the form for completeness and accuracy before submission.
15. Once finished, save your changes, and decide whether to download, print, or share the completed form.

Start your application for SPARCS data by completing the DOH-5132 form online today.