Collecting Additional Information for participants

Additional details are mostly for COPOS reporting.  

  • Military Status: Required field, Indicates if the participant is a Veteran or not. The values in drop-down are not available for editing at this moment.  See LookList Values for details.
  • Do you have a Disabling Condition?: Required field, Indicates if the participant is a disabled or not.
  • Do you have a Health Insurance?: Required field, Indicates if the participant has health insurance or not.
  • Health Insurance Source: If the participant has health insurance, then the source of that coverage can be noted. The values in drop-down are not available for editing at this moment.  See LookList Values for details.
  • Ethnicity: optional field to provide COPOS reporting on ethnicity. The values in drop-down are not available for editing at this moment.  See LookList Values for details.
  • Race: optional field to provide COPOS reporting on race. The values in drop-down are not available for editing at this moment.  See LookList Values for details.
  • Has Criminal Record:optional field, indicates if the participant has a criminal record or not.
  • Has History of Drug & Alcohol Abuse:optional field, indicates if the participant has any drug abuse history or not.
  • Current Work Status: current work status of the participant. The values in drop-down are not available for editing at this moment.  See LookList Values for details.
  • Active in Job Search: indicates if a participant is actively searching for jobs or not.
  • Disconnected Youth: required for COPOS reporting of youth in age range 14-24 who are neither working nor in school.
  • Education Level: optional field to track the education level of participants. The values in drop-down are not available for editing at this moment.  See LookList Values for details.

Collecting Veteran Information for participants

The Veteran data form is generic and is used to collect information to help veterans and retired military personnel get appropriate services and programs.  Most of the data capture is from predefined values available in drop-downs. The values in drop-down are not available for editing at this moment.  See LookList Values for details.

  • Branch of Service: select the branch of service the veteran was in.
  • Reserves only Branch: select the branch of service the veteran was in.
  • Dates of Service: From: enter the start date from when the veteran was in service.
  • Dates of Service: To: enter the last date on which the veteran retired from service.
  • Retired from service?: Note whether the veteran is still in service or retired.
  • Veteran Of Era: Which era was the veteran in service?
  • Veteran Of Police Action: If part of police action, note the name.
  • Are you eligible for the GI bill?: Note eligibility for GI bill.
  • Have you or do you use any VA medical facilities?:  Note if you are already using VA medical facilities or not.
  • VA medical facilities Used:  Note names of the facilities used.
  • Do you have a service connected disability?:  Note disabilities if any.
  • Service Connected Disability Details: Note specific details  of disabilities.
  • Percentage: Note percentage of disabilities.
  • Type of Discharge: Note type of discharge.

Collecting Disability Information for participants

The disability data form is generic and is used to document if the participant is receiving Social Security Disability(SSD) or Social Security Income (SSI).  It notes the reason for disability and the area of disability.  Most of the data capture is from predefined values available in drop-downs and limited to reason or type of disability.  The values in drop-down are not available for editing at this moment.  See LookList Values for details.

If participant is receiving Social Security Disability(SSD) or Social Security Income (SSI), then it is required to collect the following

  • Disability Reason: State the reason for disability.
  • Area of Disability: Indicate areas of disability.

Depending on the area of disability indicated, additional data captures will be required as indicated below.

  • If the area of disability is Chemical Dependency; then provide Chemical Disability Details.
  • If the area of disability is Hearing; then provide hearing disability details.
    • Hearing disability type:
    • whether or not requires Sign Language
    • whether or not requires TDD (Telecommunication Device for Deaf)
  • If the area of disability is Mobility; then provide Mobility disability Details.
  • If the area of disability is Mental Illness; then provide Mental Retardness / Development Disability Details.
  • If the area of disability is Fetal Alcohol Syndrome/ Affect; then provide Fetal Alcohol Syndrome/ Effect Details.
  • If the area of disability is Physical; then provide Physical Disability Details.
  • If the area of disability is Visual; then provide Visual Disability Details.
  • If the area of disability is Other; then provide Other Disability Details.