Exhibit_D_-_Mainstream_Service_Referral_Log.xlsx

61 KB Posted

Attached to
Master Agreement AZ|CTR066282
Contract number
CTR066282
Issued by
Arizona

About this file

Written by GovTribe AI ·

The document is an Exhibit D Mainstream Service Referral Log for the Arizona Department of Economic Security, spanning from July 2023 to June 2024. This monthly template is designed to track service referrals, with standardized columns for agency name, program, type of service, HMIS number, name of agency, date referred, comments/follow-up, and other notes.

The referral log appears to be a tracking mechanism for documenting mainstream service referrals across multiple months, likely related to economic security and social services. While the provided document is a blank template without specific entries, it suggests a systematic approach to recording and monitoring service referrals within the Arizona Department of Economic Security's programs. The consistent monthly format indicates an ongoing administrative process for tracking and managing service connections for individuals or groups seeking assistance.

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July 2023 Exhibit D Arizona Department of Economic Security Mainstream Service Referral Log

Agency Name:
Program:
Type of ServiceHMIS Number:Name of AgencyDate ReferredComments/Follow-UpOther

August 2023 Exhibit D Arizona Department of Economic Security Mainstream Service Referral Log

Agency Name:
Program:
Type of ServiceHMIS Number:Name of AgencyDate ReferredComments/Follow-UpOther

Sptember 2023 Exhibit D Arizona Department of Economic Security Mainstream Service Referral Log

Agency Name:
Program:
Type of ServiceHMIS Number:Name of AgencyDate ReferredComments/Follow-UpOther

October 2023 Exhibit D Arizona Department of Economic Security Mainstream Service Referral Log

Agency Name:
Program:
Type of ServiceHMIS Number:Name of AgencyDate ReferredComments/Follow-UpOther

November 2023 Exhibit D Arizona Department of Economic Security Mainstream Service Referral Log

Agency Name:
Program:
Type of ServiceHMIS Number:Name of AgencyDate ReferredComments/Follow-UpOther

December 2023 Exhibit D Arizona Department of Economic Security Mainstream Service Referral Log

Agency Name:
Program:
Type of ServiceHMIS Number:Name of AgencyDate ReferredComments/Follow-UpOther

January 2024 Exhibit D Arizona Department of Economic Security Mainstream Service Referral Log

Agency Name:
Program:
Type of ServiceHMIS Number:Name of AgencyDate ReferredComments/Follow-UpOther

February 2024 Exhibit D Arizona Department of Economic Security Mainstream Service Referral Log

Agency Name:
Program:
Type of ServiceHMIS Number:Name of AgencyDate ReferredComments/Follow-UpOther

March 2024 Exhibit D Arizona Department of Economic Security Mainstream Service Referral Log

Agency Name:
Program:
Type of ServiceHMIS Number:Name of AgencyDate ReferredComments/Follow-UpOther

April 2024 Exhibit D Arizona Department of Economic Security Mainstream Service Referral Log

Agency Name:
Program:
Type of ServiceHMIS Number:Name of AgencyDate ReferredComments/Follow-UpOther

May 2024 Exhibit D Arizona Department of Economic Security Mainstream Service Referral Log

Agency Name:
Program:
Type of ServiceHMIS Number:Name of AgencyDate ReferredComments/Follow-UpOther

June 2024 Exhibit D Arizona Department of Economic Security Mainstream Service Referral Log

Agency Name:
Program:
Type of ServiceHMIS Number:Name of AgencyDate ReferredComments/Follow-UpOther

File details come from the government source that posted it. Updated .