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1. Pemat Form (xls file)
   pbrn.ahrq.gov/sites/default/files/wysiwyg/professionals/prevention-chronic-care/improve/self-mgmt/pemat/pemat_form.xls
   November 01, 2013 - PEMAT Patient Education Materials Assessment Tool (PEMAT) Auto-Scoring Form   An Instrument To … You may refer to the material at any time while you complete the form. … This PEMAT Auto-Scoring Form automatically calculates an overall understandability and actionability

2. Forms and Electronic Applications | Agency for Healthcare Research and Quality
   pbrn.ahrq.gov/funding/process/app-forms/index.html
   November 01, 2015 - change from paper to electronic filing, the current PHS 398 application will be replaced by the Standard Form … Following this advice will ensure you have the latest forms and correct application package. … Research Grants Form/Application Instructions Description/Comments SF424 (R&R) (Word File, 26 … Fishers Lane Rockville, MD 20857 Phone: (301) 427-1447 Fax: (301) 427-1462 Fellowships Form … Kirschstein National Research Service Award Individual Fellowship Application Form ** to be used ONLY

3. Coaching Feedback Form (pdf file)
   pbrn.ahrq.gov/sites/default/files/wysiwyg/teamstepps/longtermcare/module9/ts2-0ltc_module9_coaching_feedback.pdf
   April 24, 2017 - Coaching Feedback Form Coaching Workshop Coaching Feedback Form INSTRUCTIONS: While observing … the scripted coaching practice exercise, use this form to document the demonstrated competencies of … particular scenario, and the observer watches the interaction and notes on the coaching observation form … Responding to Requests Following Through TeamSTEPPS 2.0 for Long-Term Care Coaching Feedback Form

4. TeamSTEPPS Coaching Feedback Form (pdf file)
   pbrn.ahrq.gov/sites/default/files/wysiwyg/teamstepps-program/tools/ts-coaching-feedback-form.pdf
   May 31, 2023 - TeamSTEPPS Coaching Feedback Form Coaching Feedback Form INSTRUCTIONS While observing the scripted … coaching practice exercise, use this form to document the demonstrated competencies of the designated … particular scenario, and the observer watches the interaction and notes on the coaching observation form … Difficult Situations Execution Responding to Requests Following Through Coaching Feedback Form

5. TeamSTEPPS Training Evaluation Form (pdf file)
   pbrn.ahrq.gov/sites/default/files/wysiwyg/teamstepps-program/tools/ts-course-evaluation-form.pdf
   June 01, 2023 - TeamSTEPPS Training Evaluation Form TeamSTEPPS Training Evaluation Form The TeamSTEPPS … course evaluation form that follows is designed for a 2 day course based on the TeamSTEPPS curriculum … include all the material covered in a 2 day course, you may need to remove sections of the evaluation form … TeamSTEPPS Training Evaluation Form 2 Location: ___________________________ Date: __________ … Additional Comments: TeamSTEPPS Training Evaluation Form

6. ASTD Coaching Self-Assessment Form (pdf file)
   pbrn.ahrq.gov/sites/default/files/wysiwyg/teamstepps-program/tools/astd-coaching-self-assessment-form.pdf
   May 31, 2023 - ASTD Coaching Self-Assessment Form … ASTD Coaching Self-Assessment Form Instructions … ☐ ☐ ☐ ☐ ASTD Coaching Self-Assessment Form 2 … ASTD Coaching Self-Assessment Form 4 … Reference: Chen, Chris, Coaching Training, ASTD, 2003 ASTD Coaching Self-Assessment Form 6 ASTD

7. CAHPS Data Research Abstract Form (pdf file)
   pbrn.ahrq.gov/sites/default/files/wysiwyg/cahps/cahps-database/data-research/cahps-data-research-abstract-form.pdf
   January 01, 2024 - CAHPS Data Research Abstract Form CAHPS Database Research Abstract Form – January 2024 1 Agency for … Healthcare Research and Quality (AHRQ) CAHPS® Database Research Abstract Form Instructions Please … use this form to describe the research for which you require AHRQ Consumer Assessment of Healthcare … Save this completed form with your last name in the file name (e.g., “Smith CAHPS Research Abstract.doc … CAHPS Database Research Abstract Form – January 2024 2 Methodology [Specify measures and proposed

8. CAHPS Data Research Abstract Form Example (pdf file)
   pbrn.ahrq.gov/sites/default/files/wysiwyg/cahps/cahps-database/data-research/example-cahps-data-research-abstract-form.pdf
   January 01, 2024 - CAHPS Data Research Abstract Form Example CAHPS Database Research Abstract Form – January 2024 1 … Agency for Healthcare Research and Quality (AHRQ) CAHPS® Database Research Abstract Form EXAMPLE … OF A COMPLETED FORM This completed abstract presents an example of how to complete this form. … Abstract Form. … CAHPS Database Research Abstract Form – January 2024

9. Team-Antibiotic-Review-Form (doc file)
   pbrn.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/improve/team-antibiotic-review-form.docx
   November 01, 2019 - AHRQ Safety Program for Improving Antibiotic Use Team Antibiotic Review Form *Questions 1–6 should … ☐ Yes ☐ No 2 Team Antibiotic Review Form AHRQ Safety Program for Improving Antibiotic Use – … Otherwise this form has been completed.

10. Form Letter | Agency for Healthcare Research and Quality
    pbrn.ahrq.gov/teamstepps/lep/handouts/lepletter.html
    December 01, 2012 - Master Trainer Course Research/Evidence Base TeamSTEPPS® Webinars Form … last reviewed December 2012 Page originally created December 2012 Internet Citation: Form

11. How to Obtain Consent for Telehealth | Agency for Healthcare Research and Quality
    pbrn.ahrq.gov/health-literacy/improve/informed-consent/obtain.html
    September 01, 2020 - and Funding How to Obtain Consent for Telehealth The purpose of consent forms … Offer to read the form aloud to all patients. … If patients consent: Mail them a copy of the consent form to keep. … If patients can’t use the patient portal, mail consent forms (one to sign and return, one to keep) and … You do not need to wait to get a consent form signed.

12. TeamSTEPPS 2.0: Coaching Feedback Form (pdf file)
    pbrn.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/teamstepps/instructor/fundamentals/module9/coachfdbk.pdf
    March 20, 2014 - TeamSTEPPS 2.0: Coaching Feedback Form TeamSTEPPS 2.0 Coaching Feedback Form – D-9-35 Coaching … Workshop Coaching Feedback Form INSTRUCTIONS: While observing the scripted coaching practice … exercise, use this form to document the demonstrated competencies of the designated coach. … particular scenario, and the observer watches the interaction and notes on the coaching observation form

13. AHRQ’s Easy-to-Understand Telehealth Consent Form | Agency for Healthcare Research and Quality
    pbrn.ahrq.gov/health-literacy/improve/informed-consent/index.html
    September 01, 2020 - Why should we use easy-to-understand telehealth consent forms? … The AHRQ Sample Consent Form must be adapted before using it. … Put your logo on the form. Check with your lawyer before using the form. … If patients cannot use a patient portal, you can mail consent forms (one to sign and return, one for … Clinicians can ask patients to sign and mail back the form.

14. Team Antibiotic Review Form | Agency for Healthcare Research and Quality
    pbrn.ahrq.gov/antibiotic-use/acute-care/improve/team-review.html
    November 01, 2019 - Stewardship Bedside Nurse Collaborate With Microbiology Lab Team Antibiotic Review Form … Ambulatory Care Toolkit Long-Term Care Toolkit Team Antibiotic Review Form … Team Antibiotic Review Form  (DOCX) Completion Guide for Team Antibiotic Review Form  (PDF … 2019 Page originally created November 2019 Internet Citation: Team Antibiotic Review Form

15. SAHL-E Test Form and User's Guide (pdf file)
    pbrn.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/quality-resources/tools/literacy/sahl-e-form-user-guide.pdf
    December 18, 2014 - SAHL-E Test Form and User's Guide The 18 items of SAHL-E, ordered according to item difficulty (keys

16. SAHL-S Test Form and User Guide (pdf file)
    pbrn.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/quality-resources/tools/literacy/sahl-s-form-user-guide.pdf
    December 18, 2014 - SAHL-S Test Form and User Guide The 18 items of SAHL-S, ordered according to item difficulty (keys

17. EvidenceNOW: Implementation Tracking Form | Agency for Healthcare Research and Quality
    pbrn.ahrq.gov/evidencenow/projects/heart-health/research-results/research/implementation-tracking-sw.html
    March 01, 2021 - Incontinence Tools for Change EvidenceNOW: Implementation Tracking Form … Implementation Tracking Note—Southwest Cooperative (PDF, 363.33 KB, 2 pages) This intervention tracking form … originally created January 2019 Internet Citation: EvidenceNOW: Implementation Tracking Form

18. EvidenceNOW: Intervention Tracking Field Note Form | Agency for Healthcare Research and Quality
    pbrn.ahrq.gov/evidencenow/projects/heart-health/research-results/research/intervention-tracking-notes-sw.html
    March 01, 2021 - Incontinence Tools for Change EvidenceNOW: Intervention Tracking Field Note Form … Southwest Cooperative Resource: Field Note Tracking Form—Southwest Cooperative (PDF, 151.3 … KB, 5 pages) This implementation tracking form was used by an EvidenceNOW Cooperative's staff to document … created January 2019 Internet Citation: EvidenceNOW: Intervention Tracking Field Note Form

19. AHRQ Grants Policy Notices | Agency for Healthcare Research and Quality
    pbrn.ahrq.gov/funding/policies/polnotice/index.html
    April 01, 2024 - and Tools (R18) Notice Number: NOT- HS-22-020 7/15/22 eRA Retirement of All Application Form … Grant Application Forms & Instructions Must be Used for Due Dates On or After January 25, 2022 - New … " Grant Application Forms and Instructions Coming for Due Dates on or after January 25, 2022 Notice … Underway Continue to Use Current Forms (FORMS-E) through May 24, 2020 Notice Number: NOT-OD-20-047 … Research Grant Applications Notice Number: NOT-OD-16-011 10/13/15 NIH & AHRQ Announce New Form

20. TeamSTEPPS Limited English Proficiency Module: Form Letter (pdf file)
    pbrn.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/teamstepps/lep/handouts/lepletter.pdf
    July 30, 2012 - TeamSTEPPS Limited English Proficiency Module: Form Letter [PLACE ON TRAINING ORGANIZER’S LETTERHEAD