Report Templates

Author: 
Federal Office of Rural Health Policy (FORHP)

Report Templates consist of the required documents submitted throughout the SHIP grant cycle to the Federal Office of Rural Health Policy (FORHP).

Topic Description Report Templates
FY 2021 Annual Report Template

This template is the attachment that you will upload to EHB for the FY 2021 Annual Report by 8/29/2022. The reporting period runs from 06/01/2021 – 05/31/2022. The following information will be requested:

  • Progress on the investments/activities for each hospital
  • Key outcomes on activities (if completed)
  • Amount of unobligated balance per hospital
  • Carryover amount and activity information (if applicable)

This project is/was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number UB1RH24206, Information Services to Rural Hospital Flexibility Program Grantees, $1,560,000 (0% financed with nongovernmental sources). This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.