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1. Forms and Electronic Applications | Agency for Healthcare Research and Quality
   preventiveservices.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

2. TeamSTEPPS Coaching Feedback Form (pdf file)
   preventiveservices.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

3. TeamSTEPPS Training Evaluation Form (pdf file)
   preventiveservices.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

4. ASTD Coaching Self-Assessment Form (pdf file)
   preventiveservices.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

5. Appendix 1-A. Permission Forms | Agency for Healthcare Research and Quality
   preventiveservices.ahrq.gov/research/publications/pubcomguide/pcguide1apa.html
   March 01, 2021 - Permission Forms Appendix 1-B. Trademarks Appendix 1-C. … *Note: Grantees may use these forms if they do not have forms of their own; however, grantees are not … Provide copies of signed forms to the managing editor. … If you already have a form that includes the elements in the talent release form, you can use it. … Permission Forms. Content last reviewed March 2021.

6. How to Obtain Consent for Telehealth | Agency for Healthcare Research and Quality
   preventiveservices.ahrq.gov/health-literacy/improve/informed-consent/obtain.html
   September 01, 2020 - Grant Application, Review & Award Process Grant Application Basics Application Forms … and Funding How to Obtain Consent for Telehealth The purpose of consent forms … Offer to read the form aloud to all patients. … 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.

7. AHRQ’s Easy-to-Understand Telehealth Consent Form | Agency for Healthcare Research and Quality
   preventiveservices.ahrq.gov/health-literacy/improve/informed-consent/index.html
   September 01, 2020 - Grant Application, Review & Award Process Grant Application Basics Application Forms … Why should we use easy-to-understand telehealth consent forms? … 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.

8. AHRQ Grants Policy Notices | Agency for Healthcare Research and Quality
   preventiveservices.ahrq.gov/funding/policies/polnotice/index.html
   March 01, 2024 - Grant Application, Review & Award Process Grant Application Basics Application Forms … Strategies 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 … Underway Continue to Use Current Forms (FORMS-E) through May 24, 2020 Notice Number: NOT-OD-20-047 … AHRQ Research Grant Applications Notice Number: NOT-OD-16-011 10/13/15 NIH & AHRQ Announce New Form

9. Supplemental Items for the CAHPS Hospital Adult Survey: Health Literacy | Agency for Healthcare Research and Quality
   preventiveservices.ahrq.gov/cahps/surveys-guidance/item-sets/literacy/suppl-healthlit-items.html
   October 01, 2023 - During this hospital stay, did you have to sign any forms?     … During this hospital stay, how often did hospital staff explain the purpose of a form before you signed … During this hospital stay, did you have to fill out any forms?     … During this hospital stay, how often did hospital staff offer you help to fill out a form?     … During this hospital stay, how often were the forms easy to fill out?    

10. Candidate Measure Submission Form (CPCF) | Agency for Healthcare Research and Quality
    preventiveservices.ahrq.gov/policymakers/chipra/cpcf-form2.html
    December 01, 2013 - Grant Application, Review & Award Process Grant Application Basics Application Forms … Children's Health Insurance Program Reauthorization Act (CHIPRA) Candidate Measure Submission Form … SHARE: Candidate Measure Submission Form … Program (PQMP) The CHIPRA Pediatric Quality Measures Program (PQMP) Candidate Measure Submission Form … Page originally created March 2013 Internet Citation: Candidate Measure Submission Form

11. Candidate Measure Submission Form (CPCF) | Agency for Healthcare Research and Quality
    preventiveservices.ahrq.gov/policymakers/chipra/cpcf-form.html
    February 01, 2014 - Grant Application, Review & Award Process Grant Application Basics Application Forms … SHARE: Candidate Measure Submission Form … (CPCF) CHIPRA Pediatric Quality Measures Program (PQMP) This Candidate Measure Submission Form … The form also requests identification of the limitations of the measure being submitted.  … Page originally created March 2013 Internet Citation: Candidate Measure Submission Form

12. CAHPS Health Literacy Item Sets | Agency for Healthcare Research and Quality
    preventiveservices.ahrq.gov/cahps/surveys-guidance/item-sets/literacy/index.html
    December 01, 2022 - Grant Application, Review & Award Process Grant Application Basics Application Forms … Communication about medicines Communication about tests and test results Communication about forms … specific topic areas for quality improvement (e.g., communication about test results, medications, and forms … comfortable discussing their health care concerns (e.g., showing interest in questions, explaining forms

13. About the CAHPS® Health Literacy Item Set for Hospitals (pdf file)
    preventiveservices.ahrq.gov/sites/default/files/wysiwyg/cahps/surveys-guidance/item-sets/literacy/about_the_health_literacy_item_set_for_hospitals_911.pdf
    October 01, 2015 - Recommended label for reporting: Ease of filling out forms H-HL24 Patient had to sign forms H-HL25 … Staff explained the purpose of a form before patient signed it H-HL26 Patient had to fill out forms … H-HL27 Staff offered patient help in filling out a form H-HL28 Forms were easy for patient to fill … H-HL25 Staff explained the purpose of a form before patient signed it H-HL27 Staff offered patient … help in filling out a form H-HL28 Forms were easy for patient to fill out H-HL29 Patient was given

14. Measures From the CAHPS Health Literacy Item Sets | Agency for Healthcare Research and Quality
    preventiveservices.ahrq.gov/cahps/surveys-guidance/item-sets/literacy/measures.html
    May 01, 2017 - Blood test, x-ray, or other test results were easy to understand Ease of Filling Out Forms H-HL25 … Staff explained the purpose of a form before patient signed it H-HL27. … Staff offered patient help in filling out a form H-HL28. … Forms were easy for patient to fill out H-HL29. … Patient was given enough time to fill out forms Please note: The CAHPS Health Literacy Item Set for

15. SOPS® Hospital Database Information and Instructions for Requesting SOPS Hospital-Identifiable Data (pdf file)
    preventiveservices.ahrq.gov/sites/default/files/wysiwyg/sops/surveys/InstructionsRequestingHosp-IdentifiableSOPSdata.pdf
    March 01, 2023 - A completed Hospital-identifiable Research Abstract Form; 2. … All completed Research Abstract Forms are reviewed by Westat to ensure completeness and clarity, and … Hospitals review data requests and send Westat signed authorization forms if they agree to release … Requester Completes Forms 2. Westat & AHRQ Review 3. Westat Contacts Database Hospitals 4. … These forms are available on the AHRQ website (https://www.ahrq.gov/sops/databases/research- datasets.html

16. TeamSTEPPS Measurement Tools | Agency for Healthcare Research and Quality
    preventiveservices.ahrq.gov/teamstepps-program/resources/tools/index.html
    January 01, 2024 - Grant Application, Review & Award Process Grant Application Basics Application Forms …  (PDF, 161 KB) This form will guide you through a self-evaluation exercise that will assist you in … observer uses this form to document the demonstrated competencies of the designated coach. … TeamSTEPPS Readiness Assessment Form (PDF, 134 KB) This PDF helps institutions answer the question … TeamSTEPPS Training: Evaluation Form (PDF, 354 KB) This course evaluation form for a two-day TeamSTEPPS

17. Facilitator Guide | Agency for Healthcare Research and Quality
    preventiveservices.ahrq.gov/patient-safety/settings/labor-delivery/perinatal-care-2/facilitator-guide.html
    July 01, 2023 - Grant Application, Review & Award Process Grant Application Basics Application Forms … In addition are links to two TeamSTEPPS documents, the coaching self-assessment form and the coaching … feedback form. … The coaching self-assessment form and feedback form are tools for self-improvement. … The feedback form can guide coaches on how to deliver feedback more effectively.

18. SOPS Research Datasets | Agency for Healthcare Research and Quality
    preventiveservices.ahrq.gov/sops/databases/research-datasets.html
    March 01, 2023 - Grant Application, Review & Award Process Grant Application Basics Application Forms … SOPS De-Identified Data Research Abstract Form (Word, 32 KB)—Researchers requesting de-identified data … must submit a completed form outlining the proposed use of the data. … Sample SOPS De-Identified Data Research Abstract Form (PDF, 376 KB)—Shows the form completed with sample … data must submit a completed form outlining the proposed use of the data.

19. Health Literacy Universal Precautions Toolkit, 3rd Edition | Agency for Healthcare Research and Quality
    preventiveservices.ahrq.gov/health-literacy/improve/precautions/toolkit.html
    February 01, 2024 - Grant Application, Review & Award Process Grant Application Basics Application Forms … Health Literacy Universal Precautions Toolkit, 3rd Edition Introduction Quick Start Guide Form … Key Strategies for Clear Communication Communication Self-Assessment Communication Observation Form … Insurance Release of Medical Information Appointment Reminder Letter Inclusive Language for Intake Forms … Contents Introduction Quick Start Guide Tools to Start on the Path to Improvement     Form a Team:

20. Research Datasets for CAHPS Surveys | Agency for Healthcare Research and Quality
    preventiveservices.ahrq.gov/cahps/cahps-database/research-datasets/index.html
    January 01, 2024 - Grant Application, Review & Award Process Grant Application Basics Application Forms … from the CAHPS Databases, please submit the following: CAHPS De-Identified Data Research Abstract Form … (PDF, 230 KB)—Please complete and submit this form to outline the proposed use of the data. … Sample CAHPS De-Identified Research Abstract Form (PDF, 247 KB)—Shows the form completed with sample … westat.com (Subject line: CAHPS De-Identified Data Request) Timeline All completed research abstract forms