Data Application Form

Module 1 Application for Data Form

This form should be used for Expressions of Interest, formal applications and requests for amendments to projects which were approved more than one year ago. Your request will be formally reviewed by the appropriate data managers in order to provide advice to the Director Generals delegate on release of data.  

Application for Data (word, 352kB)

To apply for an amendment to an existing project which was approved less than one year ago, please complete the amendment form and send it to the Data Linkage Branch Project Officer (alexandra.godfrey@health.wa.gov.au) for review. Please include relevant attachments.

Data Linkage Amendment (word, 174kB)

Module 2 Data Services

Please select the type of data service request you require. If more than one type is required (e.g. linkage and extraction) then complete all forms.

Linkage (word, 724kB) Requests for external datasets to be linked to core DOHWA datasets

Extraction (word, 761kB) Data extraction from one or more data collections

Geocoding (word, 723kB) New addresses to be assigned a geocoded point or area

Sample Selection (word, 7224kB) Sample of population to be selected from the electoral roll or other dataset (please note: this form need not be filled out if you are applying for both Cases and Controls- this is covered in the Extraction form).

Family Connections (word, 732kB) Genealogical relationships to be defined through the Family Connections System.

Module 3 Variable lists for data collections

Please select the variables required from the requested datasets. Only complete the forms for the data that is required. If you are requesting sensitive variables, please provide justification at the end of the document.

Birth (word, 165kB)

Cancer (word, 737kB)

Emergency (word, 764kB)

Mental Health (word, 793kB)

Midwives Notifications (word, 800kB)

Hospital Morbidity (word, 792kB)

Mortality (word, 175kB)

Electoral Roll (word, 59kB)

Please note: all applicants requesting Electoral Data must also complete an RM27 Form and submit it with their formal Application for Data (this does not need to be sent to the Electoral Commission). If requesting data from datasets other than those listed above, please attach a separate Word or Excel document with the required variables and Data Custodian/contact details. 

Module 4 DOHWA Human Research Ethics Committee (HREC) approval

The application form, other associated documentation and requirements for ethical review by the DOHWA HREC can be found at the DOHWA HREC website. For assistance with completing the requirements for DOHWA HREC approval please contact the HREC Executive Officer on +61 8 9222 4278 or at HREC@health.wa.gov.au

Important note: All listed analysts accessing the unit record data must sign a Confidentiality Agreement/Acknowledgment for researchers or WA public sector employees. Please see the DOHWA HREC website for these forms. All applicants applying to the DOHWA HREC in addition must provide a detailed research proposal/protocol to accompany their DOHWA Application for Data and DOHWA Application for Ethical Review.A research proposal/protocol should provide a more detailed outline of the project, in terms of the purposes and objectives of the study, the study design and proposed use of the data and any potential benefits of the research. 

Module 5 Application for Commonwealth Data

Researchers and data analysts wanting to obtain Commonwealth data should submit the Cross-Jurisdicational form below with their Expression of Interest (EOI). Feedback regarding this request will be given along with feedback from the WA data managers. If you have questions regarding Cross-Jurisdictional data or would like to discuss your project prior to submitting an EOI please contact Diana Rosman at diana.rosman@health.wa.gov.au or on +61 8 9222 4261.Application for Cross-Jurisdictional Data