South Alamo Regional Alliance for the Homeless Data Request Form

Data Request Form

South Alamo Regional Alliance for the Homeless (SARAH) is a 501(C)(3) nonprofit entity that plans and promotes efficient and effective approaches for the delivery of services to both persons experiencing homelessness and persons at-risk of becoming homeless in San Antonio and Bexar County. SARAH also serves as the local Continuum of Care (CoC) lead agency which involves providing nonprofit providers funding to develop and manage housing initiatives, reducing trauma and dislocation through immediate rehousing, promoting access and support to effective programs, and optimizing and encouraging stable housing and self-sufficiency among individuals and families experiencing homelessness.

PLEASE NOTE: You will receive an acknowledgment of submission within 24 to 72 hours of completing the SurveyMonkey. However, data requests will be reviewed and take more time to process.

Question Title

* 1. Requester’s Info

Date Request Needed (MM/DD/YYYY)

Requester's Name

Title

Organization/ Institution

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

Question Title

* 2. Access to Data
Do you have access to the Homeless Management Information System (HMIS)?

Yes

Question Title

* 3. Intended Use
(Please provide a brief description of why the requested data are needed and how the data will be used to benefit public health)

Question Title

* 4. Capacity of Data Request
(Please select in which capacity the data will be used in)

Research Project

Consultation Purpose

Academic (Thesis/Dissertation)

Other (please specify)

Question Title

* 5. Publishing of Data
Will the data be disseminated, presented, or published?

Yes

Other (please specify)

Question Title

* 6. If yes, where will it be disseminated, presented, and published? (Please note that you must receive permission before submitting for publication. You must submit a draft of the publication to SARAH at least 30 days before the official publication day, which could be the date of the conference presentation, or article in the online/or print journal).

Question Title

* 7. Data Requested
Describe in detail the information you are requesting, including specific demographic variables (e.g., gender), the time-frame of data (e.g., October 1, 2018, to September 30, 2019), and variables of interest (e.g., number of occupied beds).

Question Title

* 8. Type(s) of Calculations

Counts

Rates

Percentages

Question Title

* 9. Type of Data Requested
(A signed-data use agreement for each type of data is requested)

Non-Confidential Information (please sign and attach this form)

Confidential Information (please sign and attach this form)

Question Title

* 10. Please sign an upload your signed-data use agreement here (can be found at www.sarahomeless.org

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

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South Alamo Regional Alliance for the Homeless Data Request Form

Data Request Form

Question Title

* 1. Requester’s Info

Question Title

* 2. Access to DataDo you have access to the Homeless Management Information System (HMIS)?

Question Title

* 3. Intended Use (Please provide a brief description of why the requested data are needed and how the data will be used to benefit public health)

Question Title

* 4. Capacity of Data Request(Please select in which capacity the data will be used in)

Question Title

* 5. Publishing of DataWill the data be disseminated, presented, or published?

Question Title

Question Title

* 7. Data Requested Describe in detail the information you are requesting, including specific demographic variables (e.g., gender), the time-frame of data (e.g., October 1, 2018, to September 30, 2019), and variables of interest (e.g., number of occupied beds).

Question Title

* 8. Type(s) of Calculations

Question Title

* 9. Type of Data Requested(A signed-data use agreement for each type of data is requested)

Question Title

* 10. Please sign an upload your signed-data use agreement here (can be found at www.sarahomeless.org

* 2. Access to Data
Do you have access to the Homeless Management Information System (HMIS)?

* 3. Intended Use
(Please provide a brief description of why the requested data are needed and how the data will be used to benefit public health)

* 4. Capacity of Data Request
(Please select in which capacity the data will be used in)

* 5. Publishing of Data
Will the data be disseminated, presented, or published?

* 7. Data Requested
Describe in detail the information you are requesting, including specific demographic variables (e.g., gender), the time-frame of data (e.g., October 1, 2018, to September 30, 2019), and variables of interest (e.g., number of occupied beds).

* 9. Type of Data Requested
(A signed-data use agreement for each type of data is requested)