Form 1 screen shots

Attachment A - Screen Shots of Sample Web Form from Part A MAI Report Web Application

There are three steps included in the Part A MAI Annual Report (Step 1, Step 2A, Step 2B, and Step 3). Fields marked with a red asterisk (*) indicate that the field is editable and required. Some fields are pre-populated from the Plan report and are not editable during the Annual Report.

Step 1

Step 1 is the first page the user sees when they begin their Part A MAI Annual Report.

Figure 1: Step 1 in Part A MAI Annual Report

Step 2A

Step 2A is pre-populated with the service categories reported in the Plan report.

Figure 2: Step 2A in Part A MAI Annual Report

Step 2B

Step 2B is pre-populated with the race/ethnicity and level of effort data for each service category reported in the Plan report.

Figure 3: Step 2B in Part A MAI Annual Report

Step 3

Step 3 is the process of filling out the report sheets. There is one report sheet for each race/ethnicity group for each service category. Some fields are pre-populated from the Plan.

Figure 4: Step 3 in Part A MAI Annual Report

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