RDN Data Request

The Rural Doctors Network (RDN) is committed to improving Australia's health through the provision of timely and informative data to health stakeholders. All requests for access to data or information are via the RDN Data Request form or in writing. Only de-identified data is released and the confidentiality requirements of associated organisations is respected. If requests for data are in relation to a particular rural Division of General Practice, RDN will refer the request to that Division.

View the RDN Terms & Conditions - Privacy of Information

Before you start to complete this form, please prepare a sketch of the layout and data you require. This will assist RDN in providing you with information in the form you require. This should be emailed to database@nswrdn.com.au or faxed to 02 4924 8010 immediately after you have submitted the RDN Data Request form.

Title (Mrs/Miss/Mr/Dr. etc.):

* First Name:

* Surname:

* Occupation:

Qualifications:

* Organisation or Company Name:

Type of Organisation:

* Address:

* State:

* Postal Code:

* Telephone number:

Fax:

* Email:

1. * What will the data or information be used for?:

2. * Will the data or information be published?:

If yes, please give details:

3. If the data or information will be presented, please provide details of the name, audience composition, date and venue of the conference or forum:

4. *Will the data or information be made available to the media or press?:

If yes, please give details:

5. * Will the data or information be used in the private sector? (Commercial use of data may be subject to charges).

If yes please provide details (name of organisation or business, department, address etc):

6. How does the information or data you are requesting contribute to improving Australia's health?:

7. Are you requesting this data or information on behalf of another person or organisation?:

If yes, please provide details:

8. *Do you require data to be sub-totalled by geographic classifications? (eg RRMA, LGA, SLA, DGP, AHS).:

If yes, please provide details:

9. *What data extraction time period or point in time do you require?:

From:
To:

10.* Date Required: