List only the number of clients carried over from previous fiscal year

List only the number of new clients enrolled in program during reporting period

List total number discharged or ended involvement for any reason - successfully, unsuccessfully, or neutrally

Of the total number discharged, or ended involvement, list how many were successful

List number who continue to be engaged and will receive services in next reporting period

Number of days for residents from any county

Number of days of residents from Athens, Hocking and Vinton Counties

List average LOS in days for all residents

Defined as: Attend recovery meetings, keep counseling and case management appointments, complete 20 hours of volunteer/health/wellness programming/complete chores/attend house meetings/dinners/take part in in off-site activities as a group and attend GP programming

SSI or job income

Briefly describe achievements for reporting period

Briefly describe program challenges for reporting period

Briefly describe any program improvements made during the reporting period

Were there any significant differences between last year and this year? If so, please describe

Optional field to share additional info such as a story demonstrating how people have benefited from program

List name of staff member providing data on this form

List email address of staff member providing data on this form

List phone number for staff member providing data on this form