Public health agencies are increasingly called on to electronically exchange health information outside their jurisdictional borders. Given differences in state privacy laws and local ordinances, such exchange frequently requires a data exchange agreement. This guidance document was developed by the Joint Public Health Informatics Taskforce (JPHIT) to provide practical advice and information to public health managers and staff who craft such agreements. The guidance provided in this document includes why a particular provision might be necessary, as well as thoughtful advice to consider as you craft that provision.