RFP 5342-0 Attachment D Reffrence Form.docx

DOCX document 34 KB Posted

Attached to
MENTAL HEALTH SUPPORT EVIDENCE-BASED COMMUNITY INTERVENTION
Solicitation number
S-10000-00002545
Issued by
Marion County, Oregon

About this file

This document is the Reference Check Form for RFP 5342-2022 for a Mental Health Support Evidence-Based Community Intervention program in Oregon. The program aims to establish specific supportive interventions for individuals with mild to moderate depression, anxiety, or substance use issues to assist them in addressing or managing their symptoms. The form requests information from references about the proposer's services, customer service, problem resolution, satisfaction, timeline adherence, and cost control. The related state and local contract opportunity description indicates this program is not intended to support behavioral health treatment modalities.

This procurement does not provide any details about pricing terms, set asides, incumbents, funding requirements or sources, or other salient commercial information.

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Text version

RFP [###-####-##] – [RFP title]

ATTACHMENT F - REFERENCE CHECK FORM

RFP 5342-2022 MENTAL HEALTH SUPPORT EVIDENCE-BASED COMMUNITY INTERVENTION Att D

ATTACHMENT D - REFERENCE CHECK FORM

Proposer Name:__________________________________________
Reference Entity:__________________________________________
Reference Contact Name:__________________________________________
Contact Telephone Number:__________________________________________
Contact Email Address:__________________________________________

Please respond to the following questions:

1. For what type of services did you engage Proposer?

Describe the services listed in response to question 1.

Describe Proposer’s customer service.

Describe your satisfaction with the business relationship with Proposer.

Describe Proposer’s methods for problem resolution.

How likely would you be to use Proposer’s services again?

With which aspect(s) of Proposer’s services are you the most satisfied?

With which aspect(s) of Proposer’s services are you the least satisfied?

How well did Proposer stay within the proposed timeline?

How did the final project cost compare to the initial proposed cost?

DAS Procurement Services, Version 2.0 – December 9, 2016 Page 1 of 2 OregonBuys ID# S-10000-00002545

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