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Fiscal Reporting Forms and Templates

Request for Advance or Reimbursement Form
This form is used by local alcohol, drug addiction and mental health (ADAMH) boards and community mental health boards to request funds from the Ohio Department of Mental Health (ODMH). 

• Request for Advance or Reimbursement Form
• Numbered policy memorandum regarding the Request for Advance or Reimbursement form

DMH-FIS-040 Report
The DMH-FIS-040 report is completed annually by each alcohol, drug addiction and mental health (ADAMH) board and community mental health board and submitted to ODMH. The data provides a complete picture of the types of services provided by mental health agencies and the corresponding expenditures and revenue in the mental health system. This information is used to develop of the Annual Report, which provides the number and types of services available to severely mentally disabled people through state-operated services and community mental health agencies.

• DMH-FIS-040 form template
• Instructions for completing the DMH-FIS-040 form
• Numbered policy memorandum regarding the DMH-FIS-040 form

Other Fiscal forms