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Data Report Request

Name*

When do you need this report?*

Your requested date is less than two weeks away. Please note that most requests typically take a minimum of two weeks to complete. 

If your request is urgent, please contact Steve (campst@uw.edu) prior to submitting this form.

Briefly explain why you need this data and how it will be used.

Be as specific as possible about the output needed, using the comment box below.

For Donor List data requests, the standard output is:

ID NumbersRelationship Manager and other Adv staff
Name and Spouse NameProspect Rating
Entity InfoGiving History and Societies
AddressAlumni Status and Degrees
PhoneFaculty / Staff Status
EmailAge
Employer and Job TitleContact Preferences

For Email / Marketo data requests, the standard output is:

ID Numbers
Relationship Manager and other Adv staff
Name and Spouse Name
Prospect Rating
Entity Info
Giving History and Societies
Address
Alumni Status and Degrees
Phone
Faculty / Staff Status
Email
Age
Employer and Job Title
Contact Preferences


Please note:

  • The initial report list will include the output above. Once reviewed and confirmed, only names and emails are uploaded to Marketo.
  • If this report will be used to contact event invitees/attendees, please select "Event / Cvent" for the report type instead.

For Event / Cvent data requests, the standard output is:

ID NumbersRelationship Manager and other Adv staff
Name and Spouse NameProspect Rating
Entity InfoGiving History and Societies
AddressAlumni Status and Degrees
PhoneFaculty / Staff Status
EmailAge
Employer and Job TitleContact Preferences


*For Alumni reports, the report will also include relevant data including med program, e-year, WWAMI site, etc.

For Mailing data requests, the standard output is:

ID NumbersRelationship Manager and other Adv staff
Name and Spouse NameProspect Rating
Entity InfoGiving History and Societies
AddressAlumni Status and Degrees
PhoneFaculty / Staff Status
EmailAge
Employer and Job TitleContact Preferences


Note: If this report will be used to contact event invitees/attendees, please select "Event / Cvent" for the report type instead.

For Patient Screening data requests, the standard output is:

Wealth RatingAddress
Advance IDGender
Bridge IDEmail
Patient IDPhone
UWMC MRNBirthdate
NameRelationship Manager
Encounter DatesProvider Name


Post-event coding is used to flag entities in Advance with activity codes (e.g. event attendees and invitees).

Please be as specific as possible about the output needed. Uploads of Powerpoint slides or other files are welcome.

A "Refresh / Purge" data request is related to a previous report that was requested within the last year. 

Refresh / purge requests will have the same output as the previous version of the report, unless specified otherwise. Please provide a previous Request ID number, if available.

Note: If the original report was requested more than a year ago, please submit a new request. Contact Steve (campst@uw.edu) with any questions.

Date of Event*
Date of Event
Will this data request include patient data?*

Please note: each UW Medicine workforce member is personally responsible for appropriately handling protected health information (PHI). UW has administrative, physical and technical safeguards to ensure the confidentiality, integrity and security of electronic PHI. Reports containing PHI should never be uploaded to this form, saved on your local drive, or distributed without security protections, and UW Medicine procedures must be followed when contacting patients. 

Questions about our HIPAA policies? Please contact Ben (bjm9@uw.edu).

Will this data be used for a solicitation?*
File Upload? (Optional)
No File Chosen
File uploads may not work on some mobile devices.
REMINDER: DO NOT UPLOAD PATIENT DATA.
Please note: by default, you and your faculty/clinician will have permission to view this file.

Initial Review

Do you have additional questions for the fundraiser / requester?
These notes will be sent to the requestor for their response.

Data Request - Status Update

Your status update and the link will automatically be send to the requestor.
Do additional recipient need to receive this status update?