Application for Data

The Application for Data form has 3 different modules. Please complete the modules relevant to your application and submit according to the relevant submission instructions:

Draft Application Checklist

Final Application to DOH HREC

Please note that the forms used for the draft application are the same as for the final application.


Module 1: Application for Data Form


Module 2: Data Services

To properly understand your request, we require you to submit one or more of the following forms:

Linkage If you are interested in linking external data (e.g. results of a survey) to the DOHWADepartment of Health Western Australia datasets

If you are interested in obtaining and extract of data from the DOHWA datasets. The control selection guide may help you as well.

Geocoding If you wish to give Data LinkageA complex technique for connecting data records within and between datasets using demographic data (e.g. name, date of birth, address, sex, medical record number). Also called ‘Record Linkage’ or ‘Linkage’. a list of addresses to be geocoded.
NOTE: You don't need to submit this form if you require
SEIFASocio-Economic Indexes for Area. These values are assigned to geocoded areas and measure socioeconomic conditions. SEIFA codes can be assigned using 1996, 2001 and 2006 ABS census data./ARIAAccessibility/Remoteness Index of Australia. These values are assigned to geocoded areas and measure geographic remoteness. ARIA codes can be assigned using 1996, 2001 and 2006 ABS census data. codes on a data extract
Electoral Roll Sample Selection If you require an identifiableRelated to the identifiability of a dataset/data item; where the identity of a person/organisation is immediately obvious. sample from the WA Electoral Roll for mailout purposes.
Family Connections If you require genealogicalRelating to the history of a person, family or group. relationships.


Module 3: Variable Lists

Please complete the variable list for each dataset you require. If you are requesting data from other non-core collections please contact Tom Eitelhuber at for the variable list.

Core Datasets 

Other Datasets


Application for Ethical Review (DOHWA HREC)

For WA Health Ethics form and other ethics documentation please see the DOHWA HREC website:

Confidentiality Agreements

Please see the DOHWA HREC website for the Confidentiality Agreements that must be submitted with applications:



All amendments should first be discussed with the DLBData Linkage Branch: the specialist team at the Department of Health who are responsible for developing and maintaining the WA Data Linkage System, performing data linkage, and the facilitation of access to linked data. Project Manager, Alex Merchant ( The DOH HREC amendment form can be found at the DOH HREC website: