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SPARKS
Statewide Planning and Research
Cooperative SystemLimited and
Identifiable Data
Request Form
(DOH5132)
Instructions
SPARKS Operations
Bureau of Health Informatics
Office of Quality and Patient
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What is limited and identifiable data?
Limited and identifiable data is data that is restricted in scope and can be easily linked to a specific individual or entity.
Who is required to file limited and identifiable data?
Any individual or entity collecting or processing personal information is required to file limited and identifiable data.
How to fill out limited and identifiable data?
Limited and identifiable data can be filled out by providing accurate and specific information about the individual or entity in question.
What is the purpose of limited and identifiable data?
The purpose of limited and identifiable data is to ensure that personal information is handled responsibly and securely.
What information must be reported on limited and identifiable data?
Information such as name, address, contact details, and any other identifying information related to the individual or entity.
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