Application
Documents

Format
 
Research Data Assistance Center Checklist PDF pdf format of ma-dhcf-resdac-checklist-new-use.pdf Excel xls format of ma-dhcf-resdac-checklist-new-use.xls
Written Request to CMS PDF pdf format of ma-dhcfp-cms-request-letter.pdf Word doc format of ma-dhcfp-cms-request-letter.doc
Executive Summary PDF pdf format of ma-dhcf-executive-summary.pdf file size 2MB Word doc format of ma-dhcf-executive-summary.doc file size 5MB
Instructions for Completing Data Use Agreement (DUA) Form CMS-R00235 PDF pdf format of ma-dhcfp-dua.pdf Word doc format of ma-dhcfp-dua.doc
Addendum to Data Use Agreement (DUA) PDF pdf format of ma-dhcfp-dua-signed-user-addenda.pdf file size 1MB Word doc format of ma-dhcfp-dua-signed-user-addenda.doc file size 2MB
Specification Worksheet PDF pdf format of spec-worksheet.pdf Word doc format of spec-worksheet.doc
Privacy Board Review Summary Sheet PDF pdf format of ma division health care finance and policy-privacy Word doc format of ma division health care finance and policy-privacy
Cost Estimate Memorandum PDF pdf format of ma-dhcfp-ccw-cost-estimate.pdf Word *
* available shortly