HCUP Application Form

Online Application Order Form for Products from the Healthcare Cost and Utilization Project (HCUP)

OMB: 0935-0206

IC ID: 204300

Documents and Forms

Document Name Document Type
Form 1 HCUP Application Form Form and Instruction
1 Attachment A- HCUP DUA Agreement Training Course Attachment A - HCUP Data Use Agreement Training.docx hcup-us.ahrq.gov/tech_assist/dua.jsp Form and Instruction
2 HCUP DUA for the Nationwide Databases Attachment B - NationwideDUA.pdf hcup-us.ahrq.gov/team/NationwideDUA.jsp Form and Instruction
3 HCUP DUA for the State Databases Attachment C - StateDUA.pdf hcup-us.ahrq.gov/team/StateDUA.jsp Form and Instruction
4 Online Application Order Form Attachment D - Online Application Form.docx cdors.ahrq.gov/ Form and Instruction