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Anne Arundel County Department of Health    Data Request Form

Please complete all sections of this Data Request Form with detailed information. Requests that are incomplete or unclear will not be answered.
Submit your form at least FOUR WEEKS prior to the date data is needed. Data requests will be completed in the order they are received; therefore, some requests may take longer.
Data is subject to limitations and may not be available for every request.
**This is not a Freedom of Information Act/Maryland Public Information Act request form**
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Email *
Name *
Organization *
Phone Number
Email Address *
When do you need the data by? *
MM
/
DD
/
YYYY
For what purpose will the data be used (e.g. school assignment, community report, organization's internal plans)? A specific purpose will help us determine the most appropriate data to provide. *
Please describe in detail the specific topics for your data request. This could include any demographic or geographic breakdowns. For example, “We want data on diabetes in the county. Specifically, can we get hospital admissions for diabetes complications by zip code, sex, age and race/ethnicity for the years 2014 to 2018?” *
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