MOBI TIES 2016 Trainer Feedback Form/Program Completion Confirmation

Trainers are required to fill out this form to confirm to the MOBI/TIES office and to the Ohio Department of Health (ODH) that a MOBI or TIES program took place. The trainer is responsible for completing these forms in order to be reimbursed through your Immunization Action Plan (IAP) grant.

If you do not receive a confirmation email, it is likely the confirmation was also not received by ODH and may impact your reimbursement. Contact Melanie Farkas if this happens.