Safety Net Information and Reporting

A.     Introduction

Cicatelli Associates Inc.(CAI) manages the data collection and reporting for the Avon Breast Cancer Crusade (ABCC) Safety Net grantees. ABCC and CAI designed the data reporting to be as easy but informative as possible. The data being collected are used by the Avon Breast Cancer Crusade to demonstrate the impact of Avon funding to ABCC’s constituencies and the public. 

ABCC provides funding to different types of mammography screening and support services programs.  We have designed reporting forms for ABCC Safety Net Grantees that provide patient navigation and/or mammography screening and diagnosis.  Much of this data aligns with the ABCC Breast Health Outreach Program (Avon BHOP) data reporting requirements.

B.        Grantee Reporting Requirements

Every grantee is required to submit bi-annual progress reports, data and diagnosis reports, as well as an expenditure report at the end of their project year.  In addition, grantees are requested to report any significant media coverage.

The 2017-18 reporting schedule is as follows:




Progress Report*

7/01/17 - 12/30/17


Progress Report*

1/01/18 - 6/30/18


Media Alert Report   

Immediately after event/publicity

Final Expenditure Report   

your funding period

One month after your funding period ends

*NOTE: The Progress Reports include the Progress Narrative, Bi-Annual Data Report, and Bi-Annual Diagnostic Report. 

CAI utilizes a web-based reporting process through a secure online reporting system called Formstack. All reports should be submitted via Formstack.  A guide to Formstack can be found in the Grantees Only section of the Avon BHOP website at The login and password is avonbhop.

Approximately one month prior to your reporting deadline, CAI will send grantees a link to an electronic reporting form (e-form) on Formstack. Please note the link will change for each reporting period.  The body of the report will cover your agency’s Contact Information and Program Narrative. Your Bi-Annual Data and Diagnostic Reports, and any other supporting documentation, such as event flyers or printed materials, must be uploaded as attachments to your e-form.  Once your report is submitted, you will receive a confirmation email. Grantees may request a copy of the reports they submit by contacting CAI at

If you have additional questions or concerns about grantee reporting requirements, please contact CAI at, or contact your assigned Project Officer.

C.        Bi-Annual Progress Report – Components

Each component of the bi-annual progress report is described below. 

  1. Grantee Contact Information

This section of the report informs the CAI team of any contact changes within your program.  Please send an email to at any point during the year to update your information as changes occur.

  1. Progress Summary and Narrative

This section of the report asks you to provide a brief summary of your Avon-funded program, including your progress against the program goals listed in your Avon contract.  This form has been revised and expanded for 2017; please complete each section succinctly.  The reporting sections may vary with each reporting period. See a picture of the Report Template in Appendix A.

  1. Bi-Annual Data Reporting

Avon Breast Cancer Crusade requires all Safety Net Grantees to submit two bi-annual data reporting forms with their progress summaries. The first is a Bi-Annual Data Report that summarizes the number and types of services that Safety Net grantees provided through their Avon-funded program during the most recent six-month period.  See Appendix B for a picture of the Bi-Annual Data Report form.

The second is the Breast Cancer Diagnostic Report, which lists the number of patients served through your program who received cancer diagnoses in the 6-month reporting period. Note that the Diagnostic Report must be uploaded even if you have not had any cancer diagnoses that reporting period.  Complete the agency name and reporting period on the Form, then enter “0” on the bottom line. See Appendix C for a picture of the Breast Cancer Diagnostic Report form.

The data reports must be attached to the Bi-Annual Progress Report that you submit via Formstack.  Please use the most recent version of the Bi-Annual Data Report and Diagnostic Report forms in MS Excel format (.xls or .xlsx). The CAI team will send the Bi-Annual Data Report and Diagnostic Report forms, along with the Formstack link, at least one month prior to the due date. Incomplete, outdated forms and/or incorrect reports will be returned for revision.

D.        Media Alert Report

ABCC requests that grantees alert them of any significant media events related to your Avon-funded program.  Please use this link to access the report form in Formstack:

A picture of the online report form can be found in Appendix D.

E.         Final Expenditure Report

All grantees must submit a final expenditure report within one month of the completion of your project period. This form is provided in the email notice re: reporting deadlines and should be uploaded to Formstack when you submit your Progress Report. The expenditure report must show all project-related expenditures for the year, and explain any deviations from the Avon-approved program budget. All carryover or no-cost-extension requests should be directed to Dana Huber at

F.         Data Dictionary

Avon Breast Cancer Crusade requires all Safety Net Grantees to submit two bi-annual data reports.  The first is a Bi-Annual Data Report that summarizes the number and types of services provided through their Avon-funded program during a six-month period.  The second report is the Bi-Annual Diagnostic Report which lists key demographic data on all clients diagnosed with breast cancer by the project during the previous six-month period. Definitions for each reportable category of activity are provided below.  Changes in 2017 have been highlighted in yellow.

PLEASE BE SURE TO USE THE MOST CURRENT DATA REPORTING FORMS!!!Outdated report forms will be returned and you will need to resubmit your report on the correct form.

Be sure to complete the information at the top of each Report Form so that we are able correctly associate your data with the correct agency. Provide only data for educational, patient navigation and screening activities relevant to your Avon-funded program.

Please note that Sections I, II, III & IV must be completed by all SN Grantees.  The remaining Sections V, VI & VII, as well as the Diagnosis Report, must be completed by SN Grantees that are providing or navigating to these services with their Avon grant funds.

Each of the data elements in this report are explained below.  Should you have any questions or issues in collecting this data, please contact or your project officer.