Follow these steps to complete the DOH-5132 application for SPARCS data.
1. At the top of the form, check the box corresponding to the requested file type, either limited or identifiable data. Refer to the SPARCS Data Dictionary on the public website to help determine which file type is appropriate.
2. Provide the name, title, credentials, phone number, and email address of the Project Director who will be in charge of the study and responsible for the data.
3. List the organization and department with which the Project Director is associated and the organization's address.
4. If the contact person differs from the Project Director, provide their name and contact information.
5. Select the appropriate type of requestor to determine any applicable discounts on the data request costs.
6. Provide the project title for which you are requesting the data. This title must match the one in the research protocol for identifiable data requests.
7. Describe the purpose and objectives of the project and how the SPARCS data will be used.
8. List the specific data elements or file types being requested from SPARCS.
9. Provide details on the data security measures that will be taken to protect the requested data.
10. Obtain the required signatures from persons authorized to legally sign on the organization's behalf.
11. Describe any plans to disseminate the research results or share the data with anyone other than the authorized data user listed.
12. Submit the DOH-5132 and other documents.
For additional information please review the instructions here: https://www.health.ny.gov/forms/sparcs/doh-5132_ins.pdf.