Data Use Agreement Forms

These forms are for reference only.

To request an editable form, or for more information about GMCB's data release application process, contact gmcb.data@vermont.gov

VHCURES Schedule of Available Data

VUHDDS Schedule of Available Data

VHCURES Redisclosure Request

VHCURES Data Linkage Request

Individual User Affidavit

Publication Review Request

DUA Term Extension Request

State Agency DUA Renewal Request

Certificate of Data Destruction