The system is designed to provide data to be used in research conducted in the general public interest, which is intended for publication in a scientific journal or other national publication. By submitting this request, the user is promising to follow these guidelines. Users wishing to obtain data for other purposes should contact the States directly. HSIS staff will be pleased to provide contact names and addresses.

Before filling out the form, please review the generic variable tables to see which variables are available for a given state or the guidebooks for detailed descriptions and definitions. Table Directions (please read first) Table 1 - Accident, Vehicle, and Occupant Files Table 2 - Roadway and Roadway-Related Files Gudebooks: California, Illinois, Maine, Michigan, Minnesota, North Carolina, Ohio, Utah, and Washington

If you have any questions, please contact:
Yusuf Mohamedshah (yusuf.mohamedshah@fhwa.dot.gov)
Federal Highway Administration
HSIS Laboratory
6300 Georgetown Pike, Room T-211
McLean, VA 22101
Fax: (202) 493-3374

1. Please enter your name, contact information.

Name: *
Address 1: *
Address 2:
City: *
State: *
Zip Code: *
Telephone No: *
Fax:
Email: *
Retype Email: *

2. What is the specific research question you are addressing?:* 

3. Funding agency for this research project:* 

4. How will the results of the research be used?* 

5. When do you plan to publish the results and in which journal?* 

6. If you are a graduate student, please provide the following information:

School:
Faculty Advisor Information:
Name:
Address 1:
Address 2:
City:
State:
Zip Code:
Telephone No:
Fax:
Email:

7. When do you need this data or information from us? (NOTE: "ASAP" means we get to decide priority. If you provide a date, we will try to meet the deadline or will negotiate a new deadline with you depending on other work, the nature of the request, etc. Please be as realistic as possible.)*