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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. These are services provided on behalf of the health center by another entity via a formal written contract/agreement, where the health center is accountable for paying and/or billing ...

  3. On Form 5A Service Descriptors (PDF), you will find descriptions of the required and additional services and Form 5A Column Descriptors (PDF) provides descriptions of the three service delivery methods used by health centers.

  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 · Tips are provided to avoid gotchas, such as using the self-assessment worksheet, service descriptors, and column descriptors, as well as involving multiple staff and the project officer when completing Form 5A.

  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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