Complete the following; an * indicates the field is required. At the end of the form, click the Submit button.

Note:

  • Data requests may take up to 30 days to complete.
  • Requests must be limited to only necessary information. 
  • Requests must comply with data governance policies, including privacy, security and legal review.

Questions? Optum Health Education may be contacted here.

Contact information

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Purpose and scope

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e.g. part of an RFP
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Data specifications

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Please specify the exact data elements required for this report. Additionally, include any relevant filtering criteria, such as learner enrollment year, learner state, or other parameters that will help refine the dataset.
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Timing

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