Data Request Form

Review available data, before submitting a request, most information is available on the website.

Read through the following before submitting your data request:

If you are a member of the news media, contact the DSHS Press Office at pressofficer@dshs.texas.gov.
If you are a member of the public requesting your ImmTrac2 shot record, email ImmTrac2@dshs.texas.gov.

Fill out the entire form and provide detailed information.
All fields with an asterisk (*) must be completed.

Part 1: Requester Information

Requester Name:

Agency/Institution:

Email:

Phone:

Purpose of Request:

Date Needed By:

What question are you trying to answer with this data?

(e.g., "How many people were vaccinated with Gardasil in 2018, 2019, and 2020?")

What vaccine or vaccine preventable illness are you requesting data on?

(e.g., Varicella, Gardasil/HPV, etc.)
Note: See our Vaccines page for a list of vaccines.

What time frame are you studying?

(e.g., December 14^th, 2021–Present day, 2017–2018, etc.)

What variables would you like included?

(e.g., count of people vaccinated, count of doses administered, age of people vaccinated, etc.)

Are you looking for data about a specific population?

(e.g., specific age group, race/ethnicity, county, etc.)

Please provide a brief summary of your data request including how data will be used including public health benefits expected from use of these data:

(e.g., increase coverage rates, monitor )

Comments:

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