Statewide Planning and Research Cooperative System (SPARCS) Forms

Limited and Identifiable Data Application

• Data Governance Policy and Procedure Manual, (v3.0, May 2022)
• SPARCS Data Request Application, DOH-5132, (v4.0, April 2024)
• Instructions, (v4.0, May 2024)
• Data Requester Checklist, (v1.0, April 2024)
• Organizational Agreement, (v3.0, April 2024)
• Individual Agreement, (v3.0, April 2024)
• Security Guidelines, (v4.1, July 2024)
• SPARCS Data Request Application - Amendment, (v2.0, April 2024). Use this form to request changes to an approved project, including additional years of data.
• Affidavit of Data Destruction
• SPARCS Extension Request Form

SPARCS Data Submission

• SPARCS Compliance Exception or Extension Request Template (v2.0, March 2024)
• SPARCS Data Agreement Notification (DOH-4388)