TX HHS Form 8664. State Hospital System Data. Research. and Publication Request Application

The TX HHS Form 8664, "State Hospital System Data. Research. and Publication Request Application", is a tool used to request data from the Texas state hospital system for research or publication purposes. This form helps solve the problem of obtaining necessary data for studies or reports while ensuring that the requested information is properly secured and utilized.

Key features of this form include required information such as the requester's name, email address, and phone number, as well as the direct supervisor's contact details if the requester is a state employee. The form also requires the requester to specify which state hospital or hospitals they are requesting data from, along with the type of data being requested (individually identifiable or de-identified). Additionally, the form asks about the purpose of the request, whether it is for external or internal agency use.

This form should be used by individuals seeking access to data from the Texas state hospital system for research or publication purposes. State employees are encouraged to consult with the HHSC Ethics Office if their proposed research requires completion of Form HR0302 and obtain a signature from the Ethics Office on the supplemental signature page. The form is designed to ensure that requested data is properly secured and utilized, making it an essential tool for those working in this field.