Promising Practices collection form

First Name:
Last Name:
Title:
Email:
Phone:
Fax:
Project Description:
Time frame from when program was conducted:

State:
Type of Project:
Description of Project:
Describe value of project to your office and if or why you consider it to be innovative.

What are the short term (one-year) and longer-term implications of this activity? For example: are there follow-up activities? Where do you think the results to date will lead?

How was the project accomplished?

Describe the results of the project or initiative?

Describe the effectiveness of the project on building or enchanting collaborative relationships with other parties?

Cost and Funding Sources:

Web site where additional information or report may be located:


Outcome Measurement: Any specific impacts on rural health?

What are any quantitative and qualitative indicators that indicate the relationship of actions to meeting objectives of the office?

Have any economic impact or Return-On-Investments been done for this initiative?
Yes No
If yes, please summarize the findings.

Suggestions for SORH who may try to adapt this project:

Please attach any related guidelines, power point presentations or other materials which may be helpful to any SORH who may try to adapt your promising practice. Please note that there is a 16MB limit on file size for direct uploads. If you have a large file to add, please send it as an email attachment with all pertinent information to teryle@nosorh.org for addition to the web site.
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Promising Practices Collection Form