Scan Forms – Cover Sheet

This universal cover sheet replaces all previous cover sheets and should be used for all scan forms. Print and complete it.

The cover sheet must be completed in full and included with any scan forms submitted to Organizational Development. Information from the cover sheet allows us to track your forms and aggregate results for reporting data at various levels (state, region, county, individual, etc.).

Important Note: Any survey forms received without the cover sheet or with an incomplete cover sheet are designated “Problem Forms” and placed on hold until a complete cover sheet is submitted.

Updates on 01-29-15: “TExAS Report Number” replaced “TExAS Task Number.” For type of plan, “In-depth” and “Outreach” replaced “Outcome” and “Output.” In place of the Personnel Directory, a link to three-digit county and units codes was added (below).

Look up county and unit codes here.


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