Data Request Form

Not all calls to the WAPC are about poisonings: Exposure Versus Poisoning: What’s the Difference?

General Information

WAPC must charge a reimburse fee for labor and costs related to data preparation requested by outside organizations since we are paying a pharmacist, who would otherwise be taking emergency calls, to be offline preparing the data, which is beyond our normal scope of operations.

Please briefly describe your request and the intended use of these data:*

Requestor Name*

First Name Last Name

Email*

Phone

By providing a telephone number and submitting this form you are consenting to be contacted by SMS text message. Message & data rates may apply. You can reply STOP to opt-out of further messaging.

Your Organization Name*

Your Position*

Is your organization a non-profit?*

Yes
No

Is this request for a funded research project?*

No
Yes

Is this request being made on behalf of a third party?*

No (If yes, please identify third party below)

Disclosure Statement on WAPC Data

All data provided during the year in which the exposures occur is considered preliminary because it is possible that a case will be updated anytime during the year if new information is obtained. Changes occur in only a small number of cases each year. The Washington Poison Center does not accept responsibility for updating the requestor in the event of data updates for current year data.*

I have read and understand this statement.

Is a publication planned?*

Yes
No

The following must be included in all publications referencing WAPC data: Reporting of exposures to the poison center is voluntary and thus not mandated by law. As such, WAPC data describes the number of calls received by the poison center and most likely is an under-representation of the true occurrence of any one substance. Exposures do not necessarily represent a poisoning or overdose.*

I have read and understand this statement.

Data Details

For which years are you requesting data?*

How soon do you need the data? (Requests for data with less than 4 weeks lead-time are considered “expedited processing” and are subject to additional processing fees)*

In what form is the processed data to be delivered (check all that apply)?*

Select All
PDF file with summary numbers only
Microsoft Excel® Spreadsheet (“.xlsx” or “.csv” file format) with raw data only
Microsoft Excel® Spreadsheet (“.xlsx” or “.csv” file format) with processed data summarized in tables or pivot tables
Other (please specify):

Other data format

Is this a recurring request?

Yes
No

Please provide a detailed description of the expected resulting dataset(s), more specific descriptions allow for provision of data that best suits the project-in-question:

Please list any additional questions in regards to provision of data that may be of assistance: