Clarity HMIS Data Request Form

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PROCESS FOR DATA REQUESTS

Please fill out all fields of the Data Request Form and submit. The request will be reviewed by the RI HMIS Team and research requests require approval by the RIHMIS Steering Committee for approval at the monthly meeting. Data Requests may be denied if the request does not meet the criteria set forth in the RI HMIS Policies and Procedures. After a request is approved, a member of the RI HMIS team will send your report. If additional information is needed to fulfill your request, a team member will email you.

If you need assistance filling out the form or have any questions, please email hmis@rihomeless.org with the subject line "HMIS Report/ Data Request.

Date of Data Request *

YYYY

Requester's Name and Title *

Requester's Organization *

Please choose which option best describes your agency: *

HMIS Participating Agency

Non-HMIS Participating Agency

Research Entity (University, etc.)

Institution (Hospital, VA, Justice System Entity, etc.)

Public Agency (City department, etc.)

Other:

What kind of data are you looking for?

Aggregate information about clients, programs or services

A client or household level report in HMIS (HMIS Participating Agencies ONLY)

Client Level Data for non-HMIS participating Agency *Requires a fully executed data sharing agreement!

Clear selection

Requester's Email *

Requester's Work Phone Number *

When do you need this data by? Typically we can provide data in 5 to 7 business days *

YYYY

How do you intend to use the data? Please note: If you are publishing any reports, papers, one-pagers, or other material using HMIS data, including web postings, you are required to cite HMIS. *

Internal performance measure: use data to improve services

Research: use data for research report or other publication

Advocacy: use data to advocate or lobby for resources to end or prevent homelessness

Funding: use data in grant or funding request. (RI Coalition for the Homeless strongly recommends that determinations for HMIS data requests be given prior to submitting grant proposals that include HMIS data)

Other:

Are you going to present this data to the public or systemwide stakeholders?

If so all presentations must include complete footnotes and be sent to HMIS helpdesk for approval to confirm that the HMIS data is presented accurately

Yes

Clear selection

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