Appendix Q – CHNA Reporting to Public and IRS (U.S. Department of Treasury)
Example – Suggested Final Report – (MS Excel format)
IRS Form 990 – (Adobe Acrobat format)
IRS Form 990 Schedule H – (Adobe Acrobat format)
Example CHNA Community Summary Report (Adobe Acrobat format)
Optional Report – Physician Study
Example – Physician Study Primary Care and Specialties – (Adobe Acrobat format)
Powerpoint – Example – Physician Study Primary Care and Specialties – (MS Powerpoint format)
Optional Report – Health Resource Directory
Example – Health Resource Directory – (MS Word format)
Example – Cover for Health Resource Directory – (MS Word format)
Click on each of the steps you will find the necessary documents to complete each step
