Exhibit_D_-_Mainstream_Service_Referral_Log.xlsx

61 KB Posted

Attached to
Master Agreement AZ|CTR066290
Contract number
CTR066290
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 (DES), spanning from July 2023 to June 2024. It is a monthly tracking template designed to document service referrals, with dedicated sections for each month featuring columns for agency name, program, type of service, HMIS number, name of agency, date referred, comments/follow-up, and other potential notes.

The log appears to be a standardized reporting tool for tracking mainstream service referrals, likely related to social services, economic support, or community assistance programs. While the provided document is a blank template without specific entries, it suggests a systematic approach to monitoring and documenting service referrals across different agencies and programs within the Arizona DES ecosystem. The log's structure indicates a comprehensive tracking mechanism for referral activities, though the specific details of goods, services, pricing, or contract terms are not present in this particular exhibit.

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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 .