ORHPC Grants
Related Topics
Contact Info
Office of Rural Health and Primary Care
651-201-3838
800-366-5424 (toll-free)
Contact Info
Office of Rural Health and Primary Care
651-201-3838
800-366-5424 (toll-free)
ORHPC General Grant Forms
The forms below are general forms used for many of our grants.
If you do not see what you are looking for, please contact health.orhpc@state.mn.us, or 651–201–3838.
Index:
General forms
Budget modification forms
Expenditure reports
Other reports
General
- ORHPC Grant Guide, August 2022 (PDF)
- Applicant Conflict of Interest Disclosure (PDF)
- Due Diligence (PDF)
- MDH Grant Agreement - Sample (PDF)
Budget modification forms
- Grant Budget Modification Worksheet - basic (no indirect, no match) (Excel)
- Grant Budget Modification Worksheet - with indirect and match (Excel)
- Grant Budget Modification Worksheet - with indirect (Excel)
- HCBS Budget Adjustment Template (Excel)
Expenditure reports
- ARP SHIP Grantee's Expenditure Report (Excel), November 2021
- HCBS Employee Scholarship Grantee's Expenditure Report (Excel), updated July 2023
- MHCCCE Individual Expenditure Report has been moved to MHCCCE Individual Loan Information
- Mental Health Grants for Health Care Professionals Participant Report (Excel) June 2023
- Standard Grantee Expenditure Report, with match (Excel), updated July 2023
- Standard Grantee Expenditure Report, without match (Excel), updated July 2023
Other reports
Last Updated: 08/29/2024