PHMDC Data Services Requests

1. Contact information: *This question is required.

Name:
Email:
Phone number:

2. Date needed (mm/dd/yyyy): When do you need this by? Please allow up to four weeks to process data requests. Large and/or complex data requests may take longer to fulfill. *This question is required.

3. Purpose of the request: Provide a brief overview of your request. Context helps us understand your request, and we may know of other relevant data to help. Examples: program planning, evaluation, grant, research paper *This question is required.

4. What question(s) are you trying to answer with the data? *This question is required.

5. Who is your audience? Examples: co-workers, funders, family members, classmates, self

6. Is this request related to a past request and/or do you have a table or chart you want updated? Whom did you work with in the past? It helps us to see past correspondence and copies of the tables or charts you want us to update. This will help us connect you directly with the correct person and minimize processing time. Send related files or links to related files to us.

7. Specific data needed or desired. Examples: counts of death and counts of injury related to motor vehicle crashes

8. What time period(s) of data do you need? Examples: specific years, by month by quarter. Note that the most recent year(s) of data may not be available, depending on the data source.

9. What geography of data do you need? Examples: State, all of Dane County, by city/municipality within Dane County (such as City of Madison)

10. What is the population for whom data are being requested? Should the data be limited to certain age groups, races, ethnicities, or sex/genders? Note that we may be unable to release data for all demographics due to confidentiality and reliability of small numbers.

11. How are you planning to share the requested data? Examples: Publication, report, grant application, website

12. What is your preferred format to receive the data? Examples: Excel table, chart/graph, map, narrative

13. Is there anything else we should know?