Requester Information

All data requests will be processed by the Director of Epidemiology, Community Assessment, and Research Initiatives 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

If this request is from a news organization or other member of the media, do not fill out this form, instead email with your request.

If this is an individual requesting your personal medical record, do not fill out this form. These requests must be submitted in writing to the facility in which you were seen. If you have questions, call 478-751-6303. 

If this request is for general information (non-research): Most non-research related data requests can be filled without going through this process by accessing the Georgia Department of Public Health's Data Warehouse which is found at You can also find health assessments for each our 13 counties on our website:

If this request is for research purposes:
Please submit the following request form for requests for local public health data owned by North Central Health District or any of its 13 county health departments. Please send a copy of the Institutional IRB and DPH IRB approvals to If a DPH IRB is not required, please submit documentation that describes such.
If the data requested is owned by the Georgia Department of Public Health, please submit a data request through that office instead of here. 
If you are unsure of who owns the data, please contact your NCHD sponsor or email

Question Title

* 1. Requester Contact Information