Form VS 145 Application for California's Public Use Birth and Death Data Files - California

Form VS145 is a California Department of Public Health form also known as the "Application For California's Public Use Birth And Death Data Files". The latest edition of the form was released in March 1, 2018 and is available for digital filing.

Download an up-to-date Form VS145 in PDF-format down below or look it up on the California Department of Public Health Forms website.

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State of California - Health and Human Services Agency
California Department of Public Health
Center for Health Statistics and Informatics
APPLICATION FOR
CALIFORNIA’S PUBLIC USE
BIRTH AND DEATH DATA FILES
Application Checklist
“Application for California’s Public Use Birth and Death Data Files” filled out
completely
Signed “Data Use Agreement”
Notarized “Certificate of Acknowledgement”
Signed “Statement of Intended Use” on organization letterhead
VS 145 (3/18)
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State of California - Health and Human Services Agency
California Department of Public Health
Center for Health Statistics and Informatics
APPLICATION FOR
CALIFORNIA’S PUBLIC USE
BIRTH AND DEATH DATA FILES
Application Checklist
“Application for California’s Public Use Birth and Death Data Files” filled out
completely
Signed “Data Use Agreement”
Notarized “Certificate of Acknowledgement”
Signed “Statement of Intended Use” on organization letterhead
VS 145 (3/18)
P a g e
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State of California - Health and Human Services Agency
California Department of Public Health
Center for Health Statistics and Informatics
APPLICATION FOR
CALIFORNIA’S PUBLIC USE
BIRTH AND DEATH DATA FILES
Application Instructions
The California Birth and Death Public Use Data Files are available on CD-ROM.
Copies of data files are subject to cost recovery pursuant to H&SC 102230. Data files are provided in the
form that they were created. Data elements and file formats differ depending on the year(s) requested.
Applicants requesting regular delivery of weekly, monthly, or quarterly data files must enter into a
contract with CDPH. Payment must be received prior to the release of data. Credit card payment is not
accepted.
Send your request and payment (if applicable) to:
California Department of Public Health
Health Information and Research Section
Attn: Data Request Desk, MS 5102
P.O. Box 997410
Sacramento, CA 95899-7410
Phone: (916) 552-8095
Fax: (916) 650-6889
E-Mail:
HIRS@cdph.ca.gov
Private courier deliveries are not accepted using the P.O. Box above. If you would like to overnight the
completed application, please call or email for the physical location.
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State of California - Health and Human Services Agency
California Department of Public Health
Center for Health Statistics and Informatics
APPLICATION FOR
CALIFORNIA’S PUBLIC USE
BIRTH AND DEATH DATA FILES
Application Instructions (continued)
California makes available a public use birth and death index file. Statute specifies the data fields
that are included in the files. These are static files representing a record of each birth or death
registered in the State of California for the calendar year.
PUBLIC USE BIRTH DATA FILES (PUF-B)
The Public Use Birth data files contain six information items:
1. Last Name of Child
4. Date of Birth
2. First Name of Child
5. Sex of Child
3. Middle Name of Child
6. Place of Birth
PUBLIC USE DEATH DATA FILES (PUF-D)
The Public Use Death data files contain nine information items:
1. Last Name of Decedent
6. Place of Birth
2. First Name of Decedent
7. Place of Death
3. Middle Name of Decedent
8. Date of Death
4. Sex of Decedent
9. Father’s Last Name
5. Date of Birth
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State of California - Health and Human Services Agency
California Department of Public Health
Center for Health Statistics and Informatics
APPLICATION FOR
CALIFORNIA’S PUBLIC USE
BIRTH AND DEATH DATA FILES
Name:
Date:
Title:
Organization:
Street Address:
City:
State:
Zip Code:
Phone:
Fax:
Email:
Statement of Intended Use
Attach a signed statement of intended use on your organization’s letterhead* describing how you
propose to use the requested data, including the years and data type.
* Organization’s Letterhead is required if applicant is requesting data on their behalf.
Data Delivery
Data files will be created based on the data fields specified in Health and Safety Code (HSC)
102230 for public release. Data files are subject to cost recovery pursuant to HSC 102230.
Applicants/entities requesting regular delivery of weekly, monthly, or quarterly files must enter into a
contract with CDPH. Please indicate how frequently the data will be delivered, and you will be
contacted by CHSI staff to discuss procedures.
Data Request for Future Years
Future years of data are limited to the year of data currently available plus three ad ditional future
years. As an example, if the 2016 CCMDF Death data is the latest year available, applicants may
only request this data through 2019 (current year, plus three additional future years).
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State of California - Health and Human Services Agency
California Department of Public Health
Center for Health Statistics and Informatics
APPLICATION FOR
CALIFORNIA’S PUBLIC USE
BIRTH AND DEATH DATA FILES
Data File(s)
Please Indicate the
Frequency
\
Year(s)
W = Weekly
M = Monthly
Requested
Q = Quarterly
A = Annual
Years 1905-2017 will be delivered as an Annual file. Any requests for future years can
be delivered weekly, monthly, quarterly, or annually.
PUBLIC USE
Year(s) Requested:
BIRTH
to
W
M
Q
A
(1905-2017 available)
DEATH
to
W
M
Q
A
(1905-2017 available)
Disclaimer
Public Use data, prepared pursuant to HSC Section 102230, may not be accurate or complete due
to a variety of circumstances, including amendments to the legal records that may have been filed
after the production of the data files. Data files are not legal records and should not be used as
substitutes for the legal records from which they were derived.
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Download Form VS 145 Application for California's Public Use Birth and Death Data Files - California

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