Data Center Report Request Form

About Report Requests

Please complete the fields below to submit a report request to The NCCEH Data Center. Our staff will review the ART gallery and provide the best report to fit your needs. Report requests are processed within 2 weeks of the date of submission.

Your Name*

Title/Position*

Email Address*

Agency Name

Report Title*

Please provide a name for this request

Requested Report Delivery Date*

Report requests are processed within 2 weeks of the date of submission. If you have a particular deadline you're working with, please list it here.

Report Details

Is the data request for a specific grant?*

Select

If Yes, please attach a copy of the grant application and reporting rubric (if applicable) using the File Upload field at the bottom of this form.

Enter Grant Name

Grant Application Due Date

(if applicable)

Who will be the primary users/audience for the rep*

Select

What will the report primarily be used for?*

Select

Planned usage details:

Please provide specific details and any secondary uses/goals.

How many times will this report be run?*

Select

Report Start Date*

This should be the first report's start date in cases of recurring reports.

Report End Date*

This should be the first report's end date in cases of recurring reports.

Which HMIS Provider(s) should be included in the report?*

Please provide as much of the following as necessary: CoC Code, Project Type(s), Organization Name(s), Provider ID Number(s), Program Name (if applicable), etc.

Is there a need for visualization of report data for this request?*

If yes and a template/mockup form is available, please attach below.

Select

What level of information should the report include?*

Aggregate entails counts, sums, averages, and any other calculations based on the entire recordset. Detail entails information on individual records.

Select

Please provide any additional report requirements or useful information not addressed above

File Upload

Drag and drop files here or

Send me a copy of my responses

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