OHH Activity | Faces & Voices of Recovery Data Hub

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County:*
Type of Activity*
- Arrest
- Knock & Talk
- Surveillance Detail
- Community Event
- Training/Presentation
- Outreach
- Mobile Van Outreach
- Coordination Meeting
Location Type
- Address
- Area (Radius)
- Municipality/City
Start Date*
MM slash DD slash YYYY
Start Time*

: Hours

Minutes
End Date*
MM slash DD slash YYYY
End Time*

: Hours

Minutes
Activity Funder*
- FFY20
- SFY21
- FFY21
- SFY22
- FFY22
Names of Law Enforcement/OHH Staff*
Names of Recovery Support Staff*
# of Contacts Made
Please enter a number greater than or equal to 0.
Address
Street Address City State ZIP Code
Municipality/City
Radius

Arrest Details
Agency Type*
- State
- County
- Local
Agency Specifics
Case #'s
Material Distribution
Materials Distributed
- Select All
- Narcan
- Test Strips
- Written Materials
- Give Aways (branded items)
- Other
If Other, please provide detail
Count of Narcan*
Please enter a number greater than or equal to 0.
Count of Test Strips*
Please enter a number greater than or equal to 0.
Count of Written Materials*
Please enter a number greater than or equal to 0.
Count of Give Aways*
Please enter a number greater than or equal to 0.
Count of Other*
Please enter a number greater than or equal to 0.