Form preview

Get the free Data Request

Get Form
Please provide OCR with the following items within 3O days of receipt of this letter. If data is available electronically, please submit electronic copies, in addition to the hard copy originals either in MS Word (.doc) or Adobe Acrobat (.pdf) format. Electronic copies should be identical to and/or contain the same information as the paper copy. The electronic copies may be sent either by regular mail or as attachments through email(s) to Art.Garcia@hhs.gov.
We are not affiliated with any brand or entity on this form

Get, Create, Make and Sign data request

Edit
Edit your data request form online
Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.
Add
Add your legally-binding signature
Draw or type your signature, upload a signature image, or capture it with your digital camera.
Share
Share your form instantly
Email, fax, or share your data request form via URL. You can also download, print, or export forms to your preferred cloud storage service.

How to edit data request online

9.5
Ease of Setup
pdfFiller User Ratings on G2
9.0
Ease of Use
pdfFiller User Ratings on G2
Use the instructions below to start using our professional PDF editor:
1
Register the account. Begin by clicking Start Free Trial and create a profile if you are a new user.
2
Prepare a file. Use the Add New button. Then upload your file to the system from your device, importing it from internal mail, the cloud, or by adding its URL.
3
Edit data request. Rearrange and rotate pages, add new and changed texts, add new objects, and use other useful tools. When you're done, click Done. You can use the Documents tab to merge, split, lock, or unlock your files.
4
Save your file. Select it from your list of records. Then, move your cursor to the right toolbar and choose one of the exporting options. You can save it in multiple formats, download it as a PDF, send it by email, or store it in the cloud, among other things.
pdfFiller makes dealing with documents a breeze. Create an account to find out!

Uncompromising security for your PDF editing and eSignature needs

Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.
GDPR
AICPA SOC 2
PCI
HIPAA
CCPA
FDA

How to fill out data request

Illustration

How to fill out data request

01
Determine the specific data you need to request.
02
Identify the source or department where the data is located.
03
Prepare a formal request letter or email detailing the data needed and the purpose of the request.
04
Submit the request to the appropriate contact person or department.
05
Follow up on the request if necessary and ensure timely response.
06
Review and analyze the data once received to achieve your specific goals.

Who needs data request?

01
Government agencies
02
Researchers
03
Businesses
04
Journalists
05
Academic institutions
Fill form : Try Risk Free
Users Most Likely To Recommend - Summer 2025
Grid Leader in Small-Business - Summer 2025
High Performer - Summer 2025
Regional Leader - Summer 2025
Easiest To Do Business With - Summer 2025
Best Meets Requirements- Summer 2025
Rate the form
4.4
Satisfied
31 Votes

For pdfFiller’s FAQs

Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

pdfFiller has made it easy to fill out and sign data request. You can use the solution to change and move PDF content, add fields that can be filled in, and sign the document electronically. Start a free trial of pdfFiller, the best tool for editing and filling in documents.
You can easily do so with pdfFiller's apps for iOS and Android devices, which can be found at the Apple Store and the Google Play Store, respectively. You can use them to fill out PDFs. We have a website where you can get the app, but you can also get it there. When you install the app, log in, and start editing data request, you can start right away.
Use the pdfFiller app for Android to finish your data request. The application lets you do all the things you need to do with documents, like add, edit, and remove text, sign, annotate, and more. There is nothing else you need except your smartphone and an internet connection to do this.
Data request is a formal process of asking for specific information or data from an organization or individual.
Anyone who needs specific information or data from an organization or individual.
Data request can be filled out by submitting a formal request letter or form to the organization or individual holding the data.
The purpose of data request is to access specific information or data for a variety of reasons, such as research, analysis, or decision making.
The information required on a data request may vary depending on the specific request, but typically includes details about the requested data, purpose of the request, and contact information of the requester.
Fill out your data request online with pdfFiller!

pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.

Get started now
Form preview
If you believe that this page should be taken down, please follow our DMCA take down process here .
This form may include fields for payment information. Data entered in these fields is not covered by PCI DSS compliance.