*Please Do Not submit any Personal Identifiable Information (PII) or Protected Health Information (PHI) in your request.

The intention of this form is to aid in the process of efficiently routing data requests to the appropriate data owners within ADHS

Kindly give ADHS at least 10 business days to respond to your request. Someone may reach out to you for more information. If you don't hear back within 10 business days, please submit a Follow-Up request and include the Data Request ID you received with your initial submission.

Disclaimer - Fulfillment of data requests are at the discretion of ADHS data owners as they consider factors such as confidentiality, feasibility, and allowable purposes of the public health data. This webpage and the material contained herein are provided as a public service for informational purposes only. It should not be considered legal advice or opinion, and, unless expressly noted it does not reflect official ADHS policy.

Please visit the ADHS Data Requests website for additional information about this form or data requests.