Get Request Form For Nh Commercial Claims Public Use Data Set - Dhhs Nh

This guide provides detailed instructions on how to effectively complete the Request Form for the NH Commercial Claims Public Use Data Set. By following these steps, users can ensure their requests are submitted accurately and efficiently.

Follow the steps to complete the request form successfully.

1. Click the ‘Get Form’ button to access the form and open it in your preferred editing tool.
2. Begin filling in the requestor name field, ensuring you provide your full legal name as it will be recorded publicly.
3. If applicable, enter the requestor organization name in the corresponding section.
4. Complete the requestor address for delivery field with your current address, as this will be where the data set will be sent.
5. Select the service year(s) of data you are requesting by checking the applicable boxes for the years listed.
6. Provide a telephone number where you can be reached in case there are any issues related to the delivery of the data.
7. Enter your email address if you would like to receive updates regarding the data and any relevant studies or reports from the DHHS CHIS project.
8. Optionally, describe the expected purpose of your request in the designated field, though this information is not mandatory.
9. Review all fields for accuracy and completeness before finalizing your request.
10. Once satisfied, save your changes, and consider downloading, printing, or sharing the completed form as needed.

Start completing your request form online to access the NH Commercial Claims Public Use Data Set today.