Behavioral Risk Factor Surveillance System (BRFSS) Request

BRFSS Data Request Form
If you would like to conduct a data analysis, datasets are available in SAS, SPSS, or Excel format. For the data request, please fill out this form to help process your request. Technical assistance is available for data requests.

Name of Business/Organization/Agency:

Your Name:
Title:

Tel: Ext: Fax:

E-mail:

Preferred date to receive the data:

What are you requesting?
Dataset(s)
Analysis
Other

If you selected dataset, please provide desired format and specific years.
If you selected analysis, please explain precisely how you need the data analyzed.
If you selected other, please describe your request as best you can.

Please briefly explain your research question and analysis plan

For any kind of data request, please briefly describe the intended use of the data.

All requests will be processed in a timely manner on a first-come, first-serve basis. Once your study is finished, please provide a courtesy copy of any articles and/or reports to the Department of Health, Bureau of Epidemiology based on the BRFSS data provided from the request.

Contacts:

Melissa Murray, M.S.
Florida Department of Health
Bureau of Epidemiology
4052 Bald Cypress Way, Bin# A-12
Tallahassee, FL, 32399-1720

Tel: (850) 245-4444 Ext. 2445
Fax: (850) 922-9299