Tracking Forms
Grantees
Outreach and Enrollment Application Tracking Form
This form must be used with each client and a hard copy must be saved for a possible audit by DHS. Grantees and CAAOs must submit this form electronically within 10 days of the date stamped on the application.
Monthly Report
Grantees are required to submit a monthly report. This form is due by the 5th of the month following the month being reported.
Quarterly Report
Grantees are required to submit a Quarterly Report. The quarterly activity and budget reports are due by the 5th of the month following the quarter being reported. This report is in addition to the regular monthly report. (CAAOs do not need to fill out this report).
Certified Application Assister Organization (CAAOs)
Outreach and Enrollment Application Tracking Form
This form must be used with each client and a hard copy must be saved for a possible audit by DHS. Grantees and CAAOs must submit this form electronically within 10 days of the date stamped on the application.
Monthly Report
This is the only report required on a monthly basis for CAAOs. This form is due by the 5th of the month following the month being reported. Please do not submit a hard copy of the form. The report needs to be accessed, filled out and submitted online.
Provider Outreach Organizations
Quarterly Report
Providers are required to submit quarterly reports that include the number of applications date stamped OR assisted with for the previous three months. Additional instructions for reporting can be found within the online form. If you have questions or would like additional assistance tracking applications, feel free to contact Mary Falls-Staley.
