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HOTLINES
AIDS/STD Infoline
1-800-992-4379

Long Term Care
1-877-456-1146

Nursing Home
Complaints
1-888-810-1819

Statewide
Domestic Violence
1-888-411-1333

Reporting Forms By Quarter Due 2009-10 for Operating SBHCs

Wednesday, July 01, 2009

First Quarter Reports Due October 31		Second Quarter Reports Due January 31	Third Quarter Reports Due April 30	Fourth Quarter Reports Due June 30	Fourth Quarter Reports Due July 15
Narrative Reports
LAPERT Pages 6-19		LAPERT Pages 17-19 & 39-42	LAPERT Pages 17-29 & Chart Reviews		LAPERT Pages 17-19
ASHI Staffing Pattern Compliance Report		ASHI Staffing Pattern Compliance Report	ASHI Staffing Pattern Compliance Report		ASHI Staffing Pattern Compliance Report
Statistical Reports
ASHI Statistical Report for Contract Compliance		ASHI Statistical Report for Contract Compliance	ASHI Statistical Report for Contract Compliance		ASHI Statistical Report for Contract Compliance
Outcome Measures Reporting Form		Biannual Statistical Service Report			Outcome Measures Reporting Form
		VPN-Upload Mid-year Data Export			Biannual Statistical Service Report
					VPN-Upload Mid-year Data Export
Financial Reports
Inventory List	Inventory List		Inventory List	Inventory List
(Invoices are due the 15^th of each month, except the June invoice, which is due July 7)
				Insurance Revenue Reporting Form
				In-kind Contribution

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Due October 31