Option 3: Collect MOQA data manually

Counties can collect MOQA data using manual collection tools. CIBHS will provide PDF and Survey Monkey versions of the data collection forms and a template for compiling collected data. Follow these steps to collect MOQA data manually:

  1. Complete the MOQA Data Collection survey, select option 3.
  2. Download the PDF data collection forms below (English only) or from the Threshold Language Resources or access the correct Survey Monkey survey for the data you wish to collect.
    1. SDR Participant Survey (PDF): MOQA SDR Participant Survey - English
    2. SDR Participant Survey (Survey Monkey – English):
    3. SDR Participant Survey (Survey Monkey - Spanish): 
    4. SP Participant Survey (PDF): MOQA SP Participant Survey - English
    5. SP Participant Survey (Survey Monkey – English):
    6. SP Participant Survey (Survey Monkey - Spanish):
    7. SDR and SP Program Information (Excel): MOQA SP and SDR Program Data Reporting Template
    8. SDR and SP General Information (Survey Monkey):
    9. SDR Program Information (Survey Monkey):
    10. SP Program Information (Survey Monkey):
  3. Enter the data into the PDF form or Survey Monkey survey.
  4. Download the data export template(s) for Participant data.
    1. SDR Participant Survey Data: MOQA SDR Participant Survey Data
    2. SPP Participant Survey Data: MOQA SP Participant Survey Data
  5. Transcribe Participant data from paper forms into the data export template. Data entered into Survey Monkey will automatically transfer into the data export template; CIBHS will provide each county with an extract of all data collected via Survey Monkey for their county at the end of the pilot period.
  6. Submit Participant and Program data in Excel format to CIBHS via email (