Request for Data Information - Southern Nevada Health District

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Epidemiology

Health Care Professionals

Report a Foodborne Illness

Data Requests

Disease Reporting

Statistics, Surveillance & Reports

Epidemiology

Request for Data Information

The health district has statistical data available for Clark County only.

Request only information needed. Lengthy requests take more time to prepare.

Allow at least two weeks for fulfillment of the data request.

Internal health district requests are processed first.

* Indicates a required field
Date Needed * A value is required.Invalid format.
Requestor Information
Requestor's Name * A value is required.
Address * A value is required.
City * A value is required.	State * A value is required.	Zip * A value is required.Invalid format.
Phone Number * A value is required.Invalid format.	Fax Number * A value is required.Invalid format.
Email Address * A value is required.Invalid format.

Information Requested
Clearly describe the information required and your intended use of the data. * A value is required.

Subgroups of Interest
Race White Black Asian/Pacific Islander Native American	Sex Male Female	Ethnicity Hispanic Non-Hispanic

Please indicate crosstabulation required. (e.g. age by race)

Do you want data grouped by age? * Yes No Please make a selection. If yes, specify age grouping. (e.g. 0-4, 6-18, 65+)

What data years do you need?
Starting Date * A value is required.Invalid format.	Ending Date * A value is required.Invalid format.

Frequency of Data * By Total By Month By Quarter By Year Other Please make a selection.

Intended Use of Data
Will data be published or reproduced? * Yes No Please make a selection.
If yes, what type of publication? Internal publication or report Commercial publication for which a charge will be made Commercial publication for which a charge will not be made Academic Research Paper Web site with general access Web site with restricted access - Please provide details. Other e.g. CD ROM - please specify

Terms of Use I certify that all information provided is true and correct. I agree that the public records will not be transmitted or resold to any other person or entity without specific authorization from the County's record custodian. I agree to delete all data acquired via this request from my database and all other electronic media forms upon completion of the purpose or use or for which the request is made. I understand that if this information is provided, there may be a charge and I will have to sign an agreement for a Public Records Request. I agree not to hold the Southern Nevada Health District liable for any inaccurate or incomplete information I may receive. Please make a selection. I have read, understood and agree to the Terms of Use. *


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