Fillable Statistical Analysis Center (SAC) Data Request Form (Arizona Criminal Justice Commission)

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Statistical Analysis Center (SAC) Data Request Form (Arizona Criminal Justice Commission)

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Page 1 of 2
Updated 8/16/2019
Statistical Analysis Center (SAC)
Data Request Form
INSTRUCTIONS
Please complete all sections of the Data Request Form and submit to
aysdatarequest@azcjc.gov. SAC staff
will contact you by phone or email within five business days to verify data availability and timelines for completion.
Please note that the average completion time for a data request is 4-6 weeks upon receipt of this form.
Date Submitted:
Your Name:
Your Title:
Agency/Organization Name:
Phone: E-mail:
Reason for Request (Please describe how you will use this data):
Geographic Level(s) Needed:
☐
ZIP code
☐
County
☐
State
Names of Geographic Level(s) Needed
If multiple zip codes are listed, would you like the data run for each individual zip code or for an aggregate
of these zip codes?
☐
Individual zip codes
☐
Aggregate of zip codes
Page 2 of 2
Updated 8/16/2019
Item Questions (Please note that the number of variables selected will affect processing time. We recommend 10 or
fewer selections to ensure a completion time of 4-6 weeks):
☐ DFC NOMs ☐ 30 Day
Substance Use
☐ Lifetime Substance
Use
☐ Binge Drinking/Polysubstance
Use
☐
Perception of
Risk (Substances)
☐
Sources of
Substances
☐
Reasons for Using
Substances
☐
Reasons for Not Using
Substances
☐
Age of First Use
☐
Peer
Disapproval of
Substance Use
☐
Parent Disapproval
of Substance Use
☐
Participant Disapproval of
Peers’ Substance Use
☐
Amount of
Substance Offers
☐
Resistance
Strategies
☐
Ease of access
(Substances and
handguns)
☐
Parent-Child Conversations
regarding ATOD
☐
Parent-Child
Conversation
Factors
☐
Risk Factors
☐
Protective Factors
☐
School Safety
☐
Student-Teacher
Interactions
☐
Goal Setting
☐
Future Orientation
☐
Risky Behaviors
(e.g. impaired driving, suspended
from school, been arrested)
☐
Other (please list question
number, if known):
Years of Data Needed:
☐
2014
☐
2016
☐
2018
Demographics Needed (
Please note that the number of demographics selected will affect processing time):
We look forward to working with you to meet your data needs. If you have any questions or
concerns about the clarity of your request, or would like results from individual questions
presented in a specific way, please feel free to use the space below to list these questions and
preferences.
Notes to SAC Staff:
☐ Grade
☐ Gender
☐ Age
☐ Race/Ethnicity (American Indian/Alaska Native, Asian, African American, Hawaiian/Pacific Islander,
Multi-Racial, White, Hispanic White, Hispanic Non-White)
☐
Other (please specify):
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Statistical Analysis Center (SAC) Data Request Form (Arizona Criminal Justice Commission)

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Completed 20 July 2020

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