Activate an optimized version of the page designed specifically for screen readers.
MSQC Data and Report Request Form
To help MSQC participating hospitals fulfill their mission to improve the quality of surgical care, we aim to provide adhoc reports and data sets efficiently and accurately. This form helps us streamline your request(s) for data and/or reports by collecting the necessary information for each project.
The Data and Report Request Form will take approximately 5-10 minutes. If applicable, you will want to have available your project description/project protocol, your IRB Approval Letter, and have a clear idea of the variables you will need for your investigation.
If you have any problems or questions, please contact:
Please acknowledge/confirm the following:
I have read and understand the terms of the
MSQC Data Request Policy
MSQC will be acknowledged as a source of information in materials presented and/or published.
I attest that any publication(s) resulting from this data will meet the Patient Safety Organization (PSO) standards of contextual non-identification of patients, hospitals, and/or medical professionals and remain in accordance with the Patient Safety Act (42 CFR Part 3).
I have read and understand all of the above.
MSQC Hospital Name/Institution Name
Give a brief description of your project or research plan.
Select the type of data being requested.
Data set - case level variable information, not aggregated/adjusted
Report - table, chart, or graph of data aggregated/adjusted to display a specific outcome of interest
Survey Powered By