PDMP Data

Enter PDMP Data Source Request here.

Click "+ Add Data Source" button to add a data source

Outcome Measure: {{dataSource.pfsRequiredOutcomeMeasureSubstitutedProxyMeasure.description}} Edit

Data Source Name:
{{dataSource.dataSourceName}}

Exact wording of the proxy item and response options the grantee is requesting to substitute for the SPF-Rx Required Outcome Measure:
{{dataSource.requestedSubstituteProxyResponseOptions}}

Exact wording of the outcome that will be reported to SAMHSA/CSAP:
{{dataSource.reportedOutcomeToSamhsa}}

Formulae for calculating or deriving the prevalence estimate (reported outcomes):
{{dataSource.formulaeForCalculatingOrDerivingPrevalenceEstimate}}

Summarize how the collection and reporting of community-level SPF-Rx Required Outcome Measure was written in your approved SPF-Rx Strategic Plan:
{{dataSource.summarizeCollectionAndReporting}}

Does the requested substitution differ from what was written in your approved SPF-Rx Strategic Plan:
{{dataSource.substitutionDiffersFromPfsStrategicPlan.description}} {{dataSource.substitutionDiffersFromPfsStrategicPlan.key == 100.1 ? (' - '+dataSource.substitutionDiffersFromPfsStrategicPlanDescription):''}}

Reason for the Substitution Request:
{{dataSource.substitutionRequestReason}}

Agency/organization responsible for Data Collection:
{{dataSource.agencyOrganizationResponsibleForDataCollection}}

Substitute Data Source Request Supporting Document

For each data file, describe the contents of the data record(s) field that will be displayed:
{{dataSource.uploadedFileDescription}}