MPDS Access Request Form
Prevention Network grantees are required to enter reporting data into the Michigan Prevention Data System (MPDS) on a monthly basis for the duration of grant programs. Anyone using the system must complete required training. If you have not completed this training or are unsure, please contact your program coordinator.
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Email *
Grantee ID *
"Provider Name" as you would like it to appear in MPDS. This will be the name of the grant recipient organization, coalition, or agency. *
Who will be responsible for reporting? First and Last Name, phone number, email. You may list multiple staff/volunteers here but the first person listed will be held primarily responsible for reporting. *
Who among your paid staff/contracted staff is providing the direct services being reported? Everyone listed above will also be included in your staff list. First and last name, phone number, email. People listed here will not have access to the MPDS system. *
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