Exhibit_D_-_Mainstream_Service_Referral_Log.xlsx

XLSX spreadsheet 61 KB Posted Jul 1, 2023

Attached to: Master Agreement AZ|CTR066293
Contract number: CTR066293
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, covering monthly logs from July 2023 through June 2024. The document appears to be a template for tracking service referrals, with standardized columns for Agency Name, Program, Type of Service, HMIS Number, Name of Agency, Date Referred, Comments/Follow-Up, and Other details.

The log is structured as a monthly tracking tool with repeated blank templates for each month, designed to document service referrals for mainstream services. While the specific details of individual referrals are not populated in this document, the template suggests a systematic approach to recording and tracking service referral information for the Arizona Department of Economic Security's program(s). The consistent monthly format indicates an ongoing process for monitoring and documenting service referrals across different periods.

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CTR066293_Contract_Amendment_1.pdf	PDF	Jul 1, 2023
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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.