Public Health Action Report (Existing Awardees) Form

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Overview

OMB
PHAs

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Sheet 1: OMB

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Sheet 2: PHAs

Public Health Actions

PHA Information

Quarter

Select the project most applicable for this PHA. Leave blank if there is no related project.

Select the activity most applicable to this PHA. Leave blank if there is no related activity.

Create a concise title describing the PHA

Desribe the problem that resulted in the PHA

Select the environmental health topic most applicable to the PHA

Describe Tracking's action

Select Tracking's action type

If "Other," please explain

Output

Output Type

Planned

Start Category

Problem Category

Strategy

Quantifiable Impact

Quantifiable Impact Type

If "Other," please explain

ROI

Impact

Impact Type

Tracking Program Role Type

Setting

Population(s) Impacted

Status

Success Story