Exhibit_D_-_Mainstream_Service_Referral_Log.xlsx

XLSX spreadsheet 61 KB Posted Jul 1, 2023

Attached to: Master Agreement AZ|CTR066291
Contract number: CTR066291
Issued by: Arizona

About this file

Written by GovTribe AI · Sep 30, 2025

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

While the provided document appears to be a blank template without specific data entries, it suggests a systematic approach to tracking and managing service referrals across different months. The log is structured to capture detailed information about referrals, potentially for tracking social services, support programs, or client assistance initiatives within Arizona's economic security framework. The consistent monthly format indicates an ongoing, structured process for documenting and monitoring service referrals throughout the fiscal year.

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

Agency Name:
Program:
Type of Service	HMIS Number:	Name of Agency	Date Referred	Comments/Follow-Up	Other

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

Agency Name:
Program:
Type of Service	HMIS Number:	Name of Agency	Date Referred	Comments/Follow-Up	Other

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

Agency Name:
Program:
Type of Service	HMIS Number:	Name of Agency	Date Referred	Comments/Follow-Up	Other

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

Agency Name:
Program:
Type of Service	HMIS Number:	Name of Agency	Date Referred	Comments/Follow-Up	Other

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

Agency Name:
Program:
Type of Service	HMIS Number:	Name of Agency	Date Referred	Comments/Follow-Up	Other

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

Agency Name:
Program:
Type of Service	HMIS Number:	Name of Agency	Date Referred	Comments/Follow-Up	Other

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

Agency Name:
Program:
Type of Service	HMIS Number:	Name of Agency	Date Referred	Comments/Follow-Up	Other

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

Agency Name:
Program:
Type of Service	HMIS Number:	Name of Agency	Date Referred	Comments/Follow-Up	Other

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

Agency Name:
Program:
Type of Service	HMIS Number:	Name of Agency	Date Referred	Comments/Follow-Up	Other

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

Agency Name:
Program:
Type of Service	HMIS Number:	Name of Agency	Date Referred	Comments/Follow-Up	Other

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

Agency Name:
Program:
Type of Service	HMIS Number:	Name of Agency	Date Referred	Comments/Follow-Up	Other

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

Agency Name:
Program:
Type of Service	HMIS Number:	Name of Agency	Date Referred	Comments/Follow-Up	Other

File details come from the government source that posted it. Updated Sep 30, 2025.