017234 RFPAttD - Reference Check Form.docx

This is a Reference Check Form attachment for RFP S-44300-00017234 issued by the State of Oregon, acting through the Oregon Health Authority's Child, Family, Lifespan Behavioral Health Program, to develop and operate the Oregon Fidelity Wraparound Center for Excellence (FWC4E) for Fidelity Wraparound services. The form is designed to be completed by reference entities to evaluate proposers' qualifications and past performance. Proposers must provide information about the reference entity, contact name, telephone number, and email address as part of their submission requirements.

The Reference Check Form uses a standardized 0-10 rating scale to assess three key performance areas: overall quality of services and relationship with the proposer, delivery of service, and responsiveness to customer service issues and special requests. Each rating category includes space for detailed comments. This evaluation tool allows the Agency to verify proposer capabilities and track records through direct feedback from previous clients or business partners prior to contract award.