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 09-15-15: Added space for the names of specialists and others who need to receive a copy of the results.

Look up county and unit codes here.


Cover Sheet 09-15-15

Download form

Comments are closed.