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.