Fillable Contact Information of Requester (County of Los Angeles / Internal Services Department)

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Contact Information of Requester (County of Los Angeles / Internal Services Department)

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BROWSE COUNTY OF LOS ANGELES / INTERNAL SERVICES DEPARTMENT (CA) FORMS

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Contact Information of Requester
Name
Type of Organization:
Address
Please state your organization name.
Government Entity:
City
State
ZIP Code
Nonprofit:
Telephone
Fax
Email Address
Academic:

IMPORTANT NOTICE

This data request is specifically designed for those who are interested in obtaining mortality data in tabular format. We are currently
providing mortality data to public. The official data file for Los Angeles County is available with approximately 1.5 to 2 years delay.
All interested variables (see page 2) will be in an aggregated form. Your request may be subject to data charges; please refer to page
3 for further details.
If you are interested in obtaining brief tabulated mortality data, life expectancy tables, and/or health surveys, please visit our online
query system at:
● L.A. HealthDataNow!
http://dqs.hasten.ladhs.org/default.aspx
or if you are interested in leading causes and premature death in Los Angeles County, our annual report is available at:
● Mortality in Los Angeles County: Leading Causes of death and premature death with trends
http://publichealth.lacounty.gov/dca/dcareportspubs.htm
We do not provide any raw birth data files. Please contact the California Department of Public Health for further assistance
(http://www.cdph.ca.gov/programs/ohir/Pages/OHIRApplications.aspx
).
For any additional information, please contact the Office of Health Assessment and Epidemiology Program.
Office of Health Assessment and Epidemiology
313 N. Figueroa Street, Room 127
Los Angeles, CA 90012
Telephone: (213) 240-7785
Fax: (213) 250-2594
E-mail: DCA@ph.lacounty.gov
Tabulated Vital Statistics Data Request
1
Rev. 9/2014
Race (White, Black, Hispanic, AI, Asian/Pacific Islanders)
Available Data Years**: Varies
Sex
(Please contact the Office for more information.)
Age
Date of death
Requesting Data Year(s):
Underlying cause (ICD codes only)
Manner of death
Birthplace
City of residence
Service planning area(s)
Health district(s)
Supervisorial district(s)
Census tract(s)
* Any cell size <5 will be suppressed and excluded from the total count.
** Earlier data years may have incomplete and/or missing variables; hence, some years may have inconsistent variable fields.
Project Description
1. Clearly state the purpose of your project and how the tabulated data will be used to achieve your project’s objectives.
2. Will the requested data be used in geocoding/Geographic Information System (GIS): YES NO
If yes, please describe.
Tabulated Vital Statistics Data File*
2
Rev. 9/2014
Data Fee
For tabulation purposes, the incurred material costs consulting time and computer run, which will be charged accordingly. The
current consulting time and computing run rates are at $100.00/hour and $60/run, respectively. Notification of cost estimate will be
given prior to the commencement of data generation.
Fees are generally waived for governmental agencies and non-profit organizations.
All payments should be made to Data Collection and Analysis Unit.
Print Requester Name
Requester Signature
Title/Position
Date
Office of Health Assessment & Epidemiology Use Only
Application Received Date:
EU Authorization Signature:
Authorized Date:
3
Rev. 9/2014
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Contact Information of Requester (County of Los Angeles Internal Services Department)

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Completed 19 February 2022

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