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 crucial tool for researchers and data analysts seeking access to information from the Texas state hospital system. This form helps solve the problem of requesting and obtaining relevant data for research purposes, ensuring that all necessary information is provided and approved.

The application requires the requester to provide detailed information about themselves, including their name, phone number, email address, and supervisor's contact details if they are a state employee. The form also asks for the information owner of the requested agency data, which may be the superintendent of a specific hospital or the Associate Commissioner of the State Hospital System. Key features include the option to request de-identified data, the need to specify the type of data being requested, and the requirement to provide a list of variables or data elements.

The form is typically used by researchers and data analysts seeking access to state hospital system data for various purposes, including external research projects or internal agency uses. It is essential to complete the application questions and electronically sign the supplemental signature page, which may require additional signatures from supervisors or the HHSC Ethics Office if necessary. By filling out this form, requesters can ensure that their requests are properly processed and approved.

• The form is used for requesting state hospital system data for research purposes.
• Requesters must provide detailed information about themselves and their supervisor (if applicable).
• The form requires the specification of the type of data being requested and the list of variables or data elements.