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Report your Data The Oregon Department of Human Services asks your assistance in collecting information about where Living Well programs are being offered across Oregon and who is participating. This information helps track statewide successes and identifies additional training, funding, and other support needs.
Please note that for every set of completed data forms received for either a Living Well or Tomando Control program (the Program Summary form and all completed Participant Information forms), DHS will send back 10 Living a Healthy Life with Chronic Conditions or Tomando Control de su Salud program books.
To report program summaries and participant information, please use the forms below:
Report Online
Upcoming Programs can now be submitted online! Please send us information about all upcoming programs, whether or not they're open to the public.
Program Summaries can also be reported online! Please complete this at the end of each 6-week program you lead and submit to DHS within 2 weeks of completing the program.
Report via Fax/Mail
If you would rather mail or fax the program summaries to DHS, please use these forms: Participant Information: Please have each program participant complete this form at the end of the first session they attend. Please mail or fax completed forms to DHS (with the Program Summary) within 2 weeks of the program. DHS does not collect participant names. Faxing Instructions: Please fax documents to 971-673-0994 in care of Living Well with Chronic Conditions.
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