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Data Request Form

Data Request Form

Primary Care Intelligence Service (PCIS)

Please complete the details below to request aggregate general practice data.

On receipt of the data request form we will be in touch to discuss your requirements, including the scope and feasibility, and detail the next steps. Requests for general practice data are subject to approval by the GP Editorial Board on completion of an agreed request brief.

If you experience any issues with the form please email phs.generalpractice@phs.scot.

Fields marked with * are required.

Requestor details

Name*

Email*

Phone – Optional

Designation / Role*

Organisation*

Request details

Type of request*

Aggregate data

Short description*Provide a summary of the request and key stakeholders

Purpose*Describe the purpose of the request, rationale, policy context, expected outputs and benefits

Data requirements / Criteria*Provide details of data required, inclusion and exclusion clinical criteria (e.g., medical conditions, medications), demographics, time periods, level of data output

Use of output*

Audit

Evaluation

Quality Improvement

Other – please specify

Other use of output

Email Optional

This field is for validation purposes and should be left unchanged.

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