Online Services & Data Request Forms

Last updated on March 13, 2025

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Health Data Request Forms

Form 5424 – Request to Contact is intended for academic researchers who wish to initiate a Request to Contact study participants.

Form 5426 – Health Data Request form and associated checklists are intended to support applications for administrative health data for program planning and evaluation.

Form #	Form Name and Information
5422	Request for Information Release by the Minister of Health or Person Designated by the Minister, or by a College or a Regulatory Body for a Practitioner (PDF, 782KB)
5424	Request to Contact Potential Study Participants Using Data from Ministry of Health, a Health Authority, or a Health Authority Information Bank (Word, 55KB) Consent Letter Requirements (PDF, 77KB)
5426	Health Data Request Form (PDF, 613KB) Health Data Request Manual (PDF, 301KB)
5451	Blank Health Data Checklist (PDF, 528KB)
5456	Health Data Platform BC Organizational Access Request (PDF, 311KB)
5458	Health Data Platform BCOrganizational Access Request Amendment (PDF, 859KB)
5506	Project Closure – Declaration of Data Destruction (PDF, 553KB) Project Closure Guidelines (DOC, 190KB)
5507	Pre-Publication Disclosure Review Submission (PDF, 541KB) Information for Submission of Pre-Publication Materials for Review (PDF, 63KB)
5508	Project Closure – Declaration of Project Withdrawal (PDF, 520KB)
5509	Health Data Request – Amendment Application (PDF, 524KB)
5510	Notification of Addition/Removal of Authorized Users (PDF, 508KB)

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The B.C. Public Service acknowledges the territories of First Nations around B.C. and is grateful to carry out our work on these lands. We acknowledge the rights, interests, priorities, and concerns of all Indigenous Peoples - First Nations, Métis, and Inuit - respecting and acknowledging their distinct cultures, histories, rights, laws, and governments.

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Online Services & Data Request Forms

Health Data Request Forms