N.C. Public Health, Health and Human Services
DHHS DPH Women, Infant and Community Wellness Section For Providers and Partners Agreement Addenda, Audit Tools and Budget Forms

Women, Infant and Community Wellness Section: Agreement Addenda, Audit Tools and Budget Forms

The Women, Infant and Community Wellness Section created the Agreement Addenda to guide clinical and support services through the best practices of care, as well as the legal requirements of staffing, quality and quantity of services.

The Agreement Addenda are static documents for one year. Both the current and previous fiscal year's agreement addenda and auditing tools are provided for your convenience. Information will be updated as it becomes available.

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 FY 2022-2023 Agreement Addenda, Audit Tools, and Budget Forms - 10/11/22

 FY 2022-2023 Family Planning Agreement Addenda + Audit Tools - 10/05/22

 FY 2022-2023 Maternal Health Agreement Addenda + Audit Tools - 10/11/22

 FY 2022-2023 Maternal Health Assuring Agencies + Audit Tools 07/01/22

 FY 2022-2023 High Risk Maternity Clinic Agreement Addenda + Audit Tools - 07/01/22

 Health Behavior Intervention Audit Tool

Health Behavior Intervention Audit Tool (DHHS 4149) (PDF, KB)

 Budget Forms FY 2022-2023 - 03/08/22

 FY 2021-2022 Agreement Addenda, Audit Tools, and Budget Forms - 11/01/21

 FY 2021-2022 Family Planning Agreement Addenda + Audit Tools - 08/15/22

 FY 2021-2022 Maternal Health Agreement Addenda + Audit Tools - 09/14/21

 FY 2021-2022 Maternal Health Assuring Agencies + Audit Tools - 07/26/21

 FY 2021-2022 High Risk Maternity Clinic Agreement Addenda + Audit Tools - 09/14/21

 Health Behavior Intervention Audit Tool - 11/01/21

 Budget Forms FY 2021-2022 - 02/15/21

Last Modified: 10-11-2022