HEALTH RECOVERY SERVICES

ADOLESCENT OUTPATIENT OUTCOMES

 
 
 

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, defined as: Customer satisfies criteria for successful discharge-standard, plus return to home school, return to Bassett House, continue at Alternative school or graduates from high school.

 

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

 
 

 

Numbers Served by County

Please indicate numbers served by county of residence below. Totals for all counties should equal Number of Clients Carried over from Previous Fiscal Year + Number of New People Served

 
 
 
 
 

 

Additional Program Outcomes

 

Defined as attended three or more appointments

 

List number enrolled in program who were fully Board supported

 

List number enrolled in program who were partially Board supported

 

 

Narratives

 

Briefly describe achievements for reporting period

 
 

Briefly describe program challenges for reporting period

 
 

Briefly describe any program improvements for 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

 
 

Optional: Use file upload to attach and include any supporting documents

Drop your files here
 

 

Agency Contact

 

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

Phone
 

 

Year End Reporting Only

 

Projections

Use this section to project total number served, number who ended involvement, and number who will continue in the next fiscal year: July 1-June 30.

 
 
 

Total number who will be discharged or end involvement for any reason (successfully, unsuccessfully or neutrally)

 

Of the total number of discharge or those ending involvement, how many will be successful