Data Request Forms | Louisiana Department of Health
Source: http://dhh.louisiana.gov/bureau-of-health-informatics/ophdatarequestforms
Archived: 2026-04-23 17:22
Data Request Forms | Louisiana Department of Health
Bureau of Health Informatics
Data Request Forms
Data Request Forms
The Bureau of Health Informatics (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
.
Notice for Media Inquiries and Journalists:
If you are a reporter or journalist seeking information,
please do not use this data request form.
All media and public information requests should be submitted through the
Public Records Request process
for proper handling. To ensure your request is directed to the appropriate team, please visit our
Public Records Request page
to submit your inquiry.
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:
Name
Any location smaller than a state
All dates directly related to an individual
Telephone numbers
Fax numbers
Email addresses
Social Security Numbers
Medical record numbers
Health plan numbers
Account numbers
Certificate/license numbers
Vehicle identifiers, license plate or serial numbers
Device identifiers or serial numbers
URLs
IP Address numbers
Biometric identifiers, including fingerprints and voiceprints
Full-face or any comparable images
Any other unique identifying number or factor
Research requests for vital records data (births and deaths) require approval from a panel of reviewers, including the State Registrar and the OPH Medical Director. The following forms should be completed and uploaded to the Online Data Request Form in order for us to obtain the proper approvals:
Application for Vital Records Data (PDF)
Application for Vital Records Data (DOC)
Vital Records Confidentiality Assurance Statement
Indemnification for Use of Vital Records Data
And the appropriate list of fields being requested:
Birth Field Layout Form
Death Field Layout Form
Fetal Death Field Layout Form
If you are a researcher, your data request likely requires review by the
LDH Institutional Review Board
.
Contact
For more info, email
[email protected]
.
Surgeon General
Evelyn Griffin, MD
Secretary
Bruce D. Greenstein
Powered by
Cicero Government
Bureau of Health Informatics
Data Request Forms
Data Request Forms
The Bureau of Health Informatics (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
.
Notice for Media Inquiries and Journalists:
If you are a reporter or journalist seeking information,
please do not use this data request form.
All media and public information requests should be submitted through the
Public Records Request process
for proper handling. To ensure your request is directed to the appropriate team, please visit our
Public Records Request page
to submit your inquiry.
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:
Name
Any location smaller than a state
All dates directly related to an individual
Telephone numbers
Fax numbers
Email addresses
Social Security Numbers
Medical record numbers
Health plan numbers
Account numbers
Certificate/license numbers
Vehicle identifiers, license plate or serial numbers
Device identifiers or serial numbers
URLs
IP Address numbers
Biometric identifiers, including fingerprints and voiceprints
Full-face or any comparable images
Any other unique identifying number or factor
Research requests for vital records data (births and deaths) require approval from a panel of reviewers, including the State Registrar and the OPH Medical Director. The following forms should be completed and uploaded to the Online Data Request Form in order for us to obtain the proper approvals:
Application for Vital Records Data (PDF)
Application for Vital Records Data (DOC)
Vital Records Confidentiality Assurance Statement
Indemnification for Use of Vital Records Data
And the appropriate list of fields being requested:
Birth Field Layout Form
Death Field Layout Form
Fetal Death Field Layout Form
If you are a researcher, your data request likely requires review by the
LDH Institutional Review Board
.
Contact
For more info, email
[email protected]
.
Surgeon General
Evelyn Griffin, MD
Secretary
Bruce D. Greenstein
Powered by
Cicero Government