ASA Closed Claims Data Request


The Anesthesia Closed Claims Program offers a customized data retrieval service to ASA members for individual use or for use as a mentor. Data requests will not be granted to the general public, for commercial use or for use in litigation. Data for research will be not be granted at this time. Please check the Closed Claims webpage for a future release date. For additional guidelines related to Anesthesia Closed Claims Program data requests, please visit: www.aqihq.org/ACCMain.aspx
Create New Data Request Edit/Submit previous request

Process

  • Complete the application
  • Once the completed application is received, your application will be reviewed by the AQI staff. Please note, you may be contacted for any clarifications.
  • After the application has been reviewed, it will be sent to the Closed Claims Oversight Committee for approval.
  • When approved, you will be sent a Data Use Agreement for your review and signature.
  • When AQI receives the signed Data Use Agreement, you will receive your data.

Instruction

  • Please complete the entire form before submitting.
  • You may save your form without submitting so you will be able to edit the application.
  • Once your application has been submitted, you will not be able to make any changes.