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  1. The Form 5A service descriptors outline the general elements for all services, both Required and Additional, to assist in accurate recording of the approved Health Center Program scope of project.

  2. Form 5A Service Delivery Method Descriptors. Description. These are services provided directly by the health center and for which the health center pays and bills.

  3. 10 Αυγ 2023 · Purpose: This worksheet is a self-assessment tool for health centers to use to evaluate the accuracy of their HRSA scope of project, specifically the accuracy of Form 5A: Services Provided (Form 5A).

  4. 15 Απρ 2020 · Specifically, scope of project defines the approved service sites, services, providers, service area (s) and target population (s). This page provides information on how to accurately document scope of project and when to submit a Change in Scope (CIS) request to HRSA.

  5. Purpose: This worksheet is a self-assessment tool for health centers to evaluate the accuracy of their HRSA scope of project, specifically the accuracy of Form 5A: Services Provided (Form 5A).

  6. 17 Μαΐ 2021 · This document discusses common issues or "gotchas" health centers encounter when completing Form 5A for their scope of project. It provides guidance on how to correctly document different service delivery methods, including contracted services, telehealth, and transportation.

  7. Form 5A: Services Provided (Form 5A) A health center records approved services on Form 5A: Services Provided (PDF - 63 KB). The form lists the required and additional health services a health center provides, as well as the service delivery methods for each service.

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