Request edit access
Utah Homeless Management Information System (UHMIS) - Data Request Form
Any person or entity may request to access UHMIS data so long as that request has no intent to harm
the people represented in UHMIS data, the data is not available in an existing format that is accessible
to the researcher, the request is allowable by state and federal code, and sufficient time to process the
request is provided. 
  • We will send you an email notification as soon as we receive your request.
  • We will then review your request to determine if we may legally release the information.
  • We will contact you within 10 business days after receiving your request.
  • The request may need to be presented to the UHMIS Steering Committee for a decision.
Please refer to information in Section 6 of the UHMIS Governing Documents.
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Email *
Date of Request *
MM
/
DD
/
YYYY
Organization
(Please do not abbreviate or use acronyms)
 *
Requestor Name (Contact 1): *
Requestor Contact 1 Phone Number: *
Requestor Contact 1 Email: *
Requestor Name (Contact 2):
Requestor Contact 2 Phone Number:
Requestor Name (Contact 3):
Requestor Contact 3 Phone Number:
Requestor Contact 3 Email:
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