Forms
BHI has several methods with which to request custom data not otherwise available on our site.
To request aggregate or de-identified public health data, please complete our Online Data Request Form.
If you are an employee of DHH or a DHH contractor and are requesting access to a public health database, please complete and sign the Interoffice Request for Access to Confidential Data form and return to cphi@la.gov.
If you are an employee of DHH or a DHH contractor and are requesting data be pulled and sent to you, please use our Internal Data Request Form.
If you are an employee of another state agency, a parish or city government, or a member of the public and are requesting confidential data (see box below), a data use agreement must be executed before the data can be released. To provide the information required for a DUA, please complete and sign the External Request for Use of Confidential Data form and return to cphi@la.gov.
NOTE: If the data you are requesting contains any of the following elements, the information you are requesting is considered confidential data and is subject to a data use agreement or IRB review prior to release.
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If you are a researcher, your data request likely requires review by the LDH Institutional Review Board. Please visit the IRB website at www.dhh.la.gov/irb for information.
Any questions about these forms or requesting data from BHI should be emailed to cphi@la.gov.