Virginia All-Payer Claims Database (APCD) Request Form Logo
  • Click here to download the APCD New User Form.

    Please fill in the required information and submit your completed form to the provided point of contact below.

  • Meredith Olson

    Data Training Coordinator

    meredith.olson@vdh.virginia.gov

  • If you are interested in receiving a dataset or custom report, please email APCDsupport@vhi.org.

  • If you have any questions while completing this form, please email APCDsupport@vhi.org.

  • Virginia All-Payer Claims Database (APCD)

    Data Request Form
  • By completing this form, I confirm that I am authorized to act on behalf of my team and acknowledge the following responsibilities:


    Review and Approval
    I understand that this request will be reviewed by the Virginia APCD Data Release Committee to ensure alignment with legislative intent and compliance with Virginia Code section § 32.1-276.7:1.


    Data Subscriber Agreement
    If approved, I understand that a Data Subscriber Agreement must be fully executed before any data is released.


    Publication and Dissemination Review
    I understand that all publications, presentations, or other public disclosures resulting from Virginia APCD data must be submitted to Virginia Health Information (APCDSupport@vhi.org) and any named entities referenced in the work for a 30-day review period prior to release.


    Data Destruction
    I understand that my team must destroy all Virginia APCD data upon completion of the approved research, unless explicit permission is obtained from VHI to retain it for future use.


    Use Limited to Approved Scope
    I understand that Virginia APCD data may only be used for the specific project outlined in this request and approved by the Data Release Committee. I understand that any additional use will require a new request form submission and approval.


    Linkage and Re-Identification
    I acknowledge that intended linkage to any outside data sources must be included in this request form and approved by the Data Release Committee. I understand that re-identification of individuals or entities within the Virginia APCD is strictly prohibited and would constitute a violation of the law.

     

  • Data Applicant Information


  • If you have any questions while completing this form, please email APCDsupport@vhi.org.

  • Project Information


  • If you have any questions while completing this form, please email APCDsupport@vhi.org.

  • Data Security


  • If you have any questions while completing this form, please email APCDsupport@vhi.org.

  • Data Destruction


  • If you have any questions while completing this form, please email APCDsupport@vhi.org.

  • Additional Information Required

  • In order to complete your application, please fill out the Data Dictionary form to the best of your ability and upload below.

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  • Please upload any supplemental files (e.g., abstract, IRB approval letter, security plan) below.

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  • If you have any questions while completing this form, please email APCDsupport@vhi.org.

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