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

The Texas Health and Human Services (HHS) Form 8664-A, State Hospital System Data, Research, and Publication Request Application, is a crucial tool for requesting access to state hospital system data, research, or publication. This form helps solve the problem of ensuring that requests are properly vetted and approved, thereby maintaining the integrity and confidentiality of sensitive information.

This application requires various signatures from HHS employees, including their manager's approval, as well as potential clearance from the Ethics Office if necessary. The Information Owner, Assistant Commissioner, Deputy Assistant Commissioner, or Agency Head must also provide their signature. Additionally, the Contracts Manager may need to check specific boxes indicating whether a DUA (Memorandum of Understanding), CSPI (Confidentiality and Security Procedures for Information), or other documentation is required.

When submitting this form, HHS employees should ensure that all signatures are secured by Central Office Staff. By filling out Form 8664-A, requestors can expect a streamlined process for accessing state hospital system data, research, or publication. Key points to note include:

• The need for multiple signatures from various stakeholders
• The potential requirement for clearance from the Ethics Office
• The importance of securing all signatures through Central Office Staff