Public Health Data Request
All data requests will be processed by the district epidemiologist in the order they are received, although preference will be given to internal programs and emergent issues. Please allow 2 weeks for processing. If you have any questions regarding your data request please email
Name of Requester
Requester Phone Number
Please describe information that is being requested.
What type of information is needed?
Check all that apply.
Please provide a date the information is needed by.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service