Request ECIDS Data Access

Personal Information

First Name*

Last Name*

Title/Credential/Degree*

Email*

Confirm Email*

Phone Number*

Organization*

Organization Website URL*

Length of time with the organization*

Supervisor Email*

Please list any additional collaborators you may be working with related to this data request.

Data Access

1. Please select the ECIDS data sources that you are interested in*:

2. What type of ECIDS data are you interested in (See a list of available reports here)?*

Other, please explain*:

3. What timeframes of ECIDS data are you interested in (See data availability for programs here)?*

4. Which regions (zip codes or counties) of Utah are you interested in, or statewide?*

Data Use *If responses are not specific your request may be rejected

5. Please be specific in describing how you intend to use ECIDS data.*

6. Please be specific in describing how you intend to use ECIDS data.*

7. Please be specific in describing the format and method(s) for your ECIDS data sharing.*

8. How frequently do you intend to analyze and/or share ECIDS data? *

9. Please be specific in what type of analysis you intend to do? *

10. If you know your research questions and/or hypothesis please be specific in describing that here.

Disclaimer: Access is granted by the ECIDS Data Governance Committee for a period of 12 months from the time of approval. Once that period has expired, a new access request form must be submitted and approved.

This information is requested in order to approve your access to ECIDS. Incomplete information will result in denial of your request. This information is stored in accord with the transitory correspondence General Retention Schedule GRS-1759.