Arizona Hospital Discharge Data
Total Page:16
File Type:pdf, Size:1020Kb
MAIL this Data Use Agreement, the Application form, supporting documentation and payment by check or money order only to :
Arizona Department of Health Services Bureau of Public Health Statistics Section of Cost Reporting and Discharge Data Review 150 North 18th Ave - Suite 550 Phoenix AZ 85007-3248
Requestor information:Principal Requestor Name: E-Mail: Phone: Organization Name: