Certification Activity Report

Agency Type

Select the type of agency to be included in this report. This field is required.

Agency Available

Select the agency(ies) to be included in the report., then click Add>>.

Agency Selected

This field displays the agency(ies) selected from the previous field.

Provider ID

To generate a report for a certain provider, enter the provider's system-generated ID number. No other parameters are necessary.

Provider Type Available

Select the provider type(s) to be included in this report.

Provider Type Selected

This field displays the provider type(s) selected in the previous field.

Level of Care

Select the level of care to be included in this report.

Date Type

Select the date type, either certification date or expiration date. This field is required.

From Date

Enter the beginning date of the range when the records were certified or expired, depending on the date type.

To Date

Enter the ending date of the range when the records were certified or expired, depending on the date type.