EVV Form Tracker
GPS Auth Form Tracker for ODA and DODD clients who use EVV for services.
Clients Name
*
EVV Consent Form Signed Correctly by client in all sections?
Yes
No
Was a copy given to the client? How so?
Original given to client
Mailed them a copy
Digital copy sent by email
Digital copy sent by Docusign
Digital copy sent by Jotform
Date the EVV Form was signed?
-
Month
-
Day
Year
Date
File Upload
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of
Admin
First Name
Last Name
Signature
Date
-
Month
-
Day
Year
Date
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Should be Empty: