Program Evaluation – Final Report Requirements

The Advisory Board of the Physician’s Charitable Foundation thanks you for your interest in our community and is pleased to award a grant for your program. In order to monitor the progress of our grantees and build greater consistency in how grantees report on their progress and accomplishments, we are asking you to follow our reporting format. Your candid responses to the will help us better reflect on the impact of your work.

It is requested that you submit the report within a one year time frame. If your entire project has not been completed within one year or the funds have not been totally used, please tender an interim report regarding the status of the project. Your organization will not be eligible for future funding until an interim report or final report has been received, whichever is appropriate.

Program Reflection

    1. What progress have you made toward achieving the outcomes identified?
    2. What changes (if any) were made to the original design?
      1. What progress have you made toward achieving the outcomes identified? Explain why the changes were made.
      2. What impact did these changes have on your program?
    3. Please share any additional information or thoughts you would like us to know about your program, organizational challenges, industry trends, client population, community issues, etc.

    Supporting Documentation

    1. Please provide an updated budget for which the grant resources were used that itemizes revenues and expenses to date.
    2. Describe any budget changes that occurred during implementation.

Report Submission
Please limit your report to 3 pages maximum and submit 1 copy only.

Reports should be mailed to:

Nancy Hines, RN
Executive Director
Physicians’ Charitable Foundation
40 North Main Street, Suite 500
Dayton, OH 45423