Applicant Information

The top section contains general applicant information, as well as auto-populated status updates which are contained in grey fields. Below, you will find five tabs. You will need to navigate to each of these tabs to input and save information. Each tab has its own Save Draft button. Use this button to update the application while navigating.

Applicant Information 1

Use the paperclip button at the top of the application to attach any supporting documentation that is unrelated to funding requests. This includes supporting documentation for evaluation criteria. Include supporting documentation for funding requests in the Funding Request Detail window.

Applicant Information 2

Once you input general Lead HCP information and save the application, two tabs will appear at the bottom of the page: Health Care Provider and Funding Request Details. These tabs will contain at least the lead HCP and all funding requests associated with the application.

Applicant Information 3

You must complete each of the identified sections or tabs in order to submit the application. The table below summarizes the requirements of each section.


General Information Contains identifying information for the application and Lead HCP
Contact Information Contains contact information for POCs for the application
Application Evaluation Metrics Contains drop-down responses and fields requesting additional information needed to award points based on the evaluation metrics outlined in the Report and Order
Purpose and Intent Contains free response questions describing the intended use of the COVID-19 Telehealth Program funding
Funding Request

Summarizes the total funding requested in the application. Note: This amount is automatically calculated based on the information provided in the funding request details

Certification Provides for certification and submission of all information entered
Health Care Provider Contains an entry for the lead HCP for the application
Funding Request Details

Contains fields requesting additional information about the items and services requested for funding