Program Annual Report

STEP BY STEP PROCESS:

CONTINUAL ACCREDITATION: To maintain accreditation, the Accredited Program must submit an annual report and applicable nonrefundable fee no later than June 30th every year with exception to the year of initial accreditation/re-accreditation. See Program Annual Report.

Who should complete the Program Annual Report - This form should be submitted by the designated representative (Accreditation File Builder) for the Organization. You may start the Program Annual Report, save it, and complete it later.

REMINDER: You may begin the Annual Report on March 1st. The Program Annual Report is due by June 30th, every year. Providers (behavioral health and education) must complete the Annual Report to maintain accreditation.

Name of person submitting Program Annual Report. *

Title *

PROVIDER INFORMATION

Name of Organization *

Provider Type *

Behavioral Health - $300

Education -$250

Physical Address *

City *

State *

Zip Code *

Country

Phone

Alternate Phone

Email Address *

Website