Reporting Templates. Response Time Performance Provider Period Date Urban Rural Remote Immediately Life threatening emergency incidents Potentially life threatening emergency incidents Immediately Life threatening emergency incidents Potentially life threatening emergency incidents Immediately Life threatening emergency incidents Potentially life threatening emergency incidents 50% 95% 80% 50% 95% 80% 50% 95% 80% 8 minutes 20 minutes 20 mintues 12 minutes 30 minutes 30 minutes 25 minutes 60 minutes 60 minutes Jul-09 Sep-09 Oct-09 Nov-09 Dec-09 Mar-10 Apr-10 May-10 Jul-10 Sep-10 Oct-10 Nov-10 Dec-10 Jan-11 Feb-11 Mar-11 Apr-11 May-11 Jun-11 Jul-11 Volume Reporting Provider Period Date Volume of incidents attended where there was no patient transported Volume of incidents attended where there was at least one patient transported Immediately life threatening Potentially life threatening Non-emergency Sep-09 Oct-09 Nov-09 Dec-09 Mar-10 Apr-10 May-10 Jul-10 Sep-10 Oct-10 Nov-10 Dec-10 Jan-11 Feb-11 Mar-11 Apr-11 May-11 Jun-11 Jul-11 Front Line Staffing Provider Period Date ALS ILS BLS Total Full Time Equivalent Paid Establishment Full time Equivalent vacancies for paid positions Headcount of volunteers Appendix 4: Allocating the Severity Assessment Code (SAC Score) Source: xxxx://xxx.xxx.xxxx.xx/moh.nsf/indexmh/improvingquality-reportableevents-resources Appendix 5: Serious and Sentinel Events Quarterly Reporting Template Incidents - Quarterly Report Reported by: (name) Operator: (select) Date Reported: (date) Year: 2010/11 Quarter: (select) Required fields Required for SAC1 and SAC2 events (not required for SAC3 & SAC4) If known: Organisation Event Ref Date Reported to NASO Type of Incident Date of incident Region Serious, Sentinel or Adverse Actual / Potential (Near Miss) Actual Severity Assessment Code (SAC) Score Incident Category Description of what happened and immediate actions taken Final SAC Score (following investigation / mitigation) Findings/Outcome of Investigation Recommendations Mitigation (Investigation / Response / Actions) Media coverage (if any) Media Story (if any) Complaint? Incident Number (select) (select) (select) (select) (select) (select) (select)
Reporting Templates. The reporting template(s) will be determined once funding has been approved.
Reporting Templates. Template 1 - Provider Tangible Property Inventory Form Template 2 - SAMH Block Grant Reporting Template Template 3 - Narrative Report for the Substance Abuse and Mental Health Block Grant Template 4 - Managing Entity Annual Business Operations Plan Template 5 - ALF-LMH Forms Template 6 - Behavioral Health Network Participant Forms Template 7 - BNet Alternative Service Forms Template 8 - Discontinued 11/3/2016 Template 9 - Local Match Calculation Form Template 10 - Managing Entity Monthly Fixed Payment Invoice Template 11 - Managing Entity Monthly Progress Report Template 12 - Managing Entity Monthly Expenditure Report Template 13 - Managing Entity Monthly Carry Forward Expenditure Report Template 14 - Cost Allocation Plan Template 15 - Managing Entity Spending Plan for Carry Forward Report Template 16 - Women's Special Funding Report Template 17 - Discontinued Effective 7/1/2020 Template 18 - Discontinued Effective 5/18/2017 Template 19 - PFS Drug Epidemiology Network (DEN) Report Template 20 - CMHSOC Reporting Template Template 21 - Care Coordination Monthly Report Template 22 - Forensic Mental Health Services Report Template 23 - Forensic Diversion Report Template 24 - CCP Invoice and Expenditure Report Template 25 - Forensic Multidisciplinary Team Report Template 26 - Discontinued Effective 7/1/2021 Template 27 - PFS School-Based Prevention Quarterly Report Template 28 - Mobile Response Team Report Template 29 - FACT Quarterly Report Template 30 - Proviso Project Return on Investment (ROI) Report Template 31 - Clubhouse Supported Employment Report Template 32 - Transitional Voucher Incidental Report
Reporting Templates. When reporting to the Province, the Recipient will use the templates provided by the Province (if any). Supporting Documentation For clarity, the Province may request supporting documentation from the Recipient as part of the Reports submitted as described in this schedule. Report Details
Reporting Templates. Each partner involved in an action of dissemination of the project should update a brief report of activities, using the templates provided Annex I and II, to describe the action that has been carried out. The tables are then sent to the partners responsible for the dissemination so that an update of all the activities can be made. Inputs will also feed into updates of the Dissemination Plan. The report needs to be completed every time a partner takes part of an action in which dissemination of the project is made. For example, it will be completed when a partner attends or organizes a meeting or a press conference, when they send information to the media to achieve the publication of an article. The reporting templates provided in Annex I will be used when a partner performs any of the following tasks: 2 Please see xxxx://xxx.xxxxxxx.xx/damesuplementos/salud/2013-04-07_SAL/index.html#/27/zoomed. . • Attend/organize European/international event • Attend/organize a workshops • Give a seminar • Attend fairs or exhibitions While reporting template in Annex II will be used when partners: • Publish articles in a specialized magazine • Publish articles in a local/regional/national magazine or newspaper • Carry a communication campaign • Release press conference, blog posts etc. • Provide general information to consumers 8 Creating synergies BIOPOOL project has started with the aggregation of data available from eight biobanks across Europe. However, members of BIOPOOL are active in contacting biobanks worldwide to invite them, under a set of conditions agreed by the consortium, to collaborate with the project taking part of the virtual histological database network. The aim is to double the number of initial biobanks providing their pools, up to sixteen at the end of project. In the last month the project Coordinator, Xxxxxxx Xxxxxx, has established contacts with a number of Biobanks, both within Europe and outside Europe. These biobanks may be invited to a meeting in which they will illustrate their potential contribution to BIOPOOL project.
Reporting Templates. JSL’s standard reporting templates for the reports required under Clause 9 available upon request; Requests for Information will have the meaning set out in FOIA or any apparent request for information under the FOIA or the Environmental Information Regulations; Quarterly Service Revenue Report The quarterly service revenue report to be provided by the Contractor to JSL under Clause 9.3; Sensitive Personal Data means Personal Data that incorporates such categories of data as are listed in Article 9(1) of the GDPR; Services means the telecommunications services to be provided by the Contractor falling within the categories or lots set out in Schedule 1 which may be provided to Customers under a Contract; and Service Reports reports to be provided by the Contractor to JSL comprising: (i) monthly service report and (ii) quarterly service revenue statement as required under Clause 9; Term means the term of this Agreement as set out in Clause 3.
Reporting Templates. When reporting to the Province, the Recipient will use the templates provided by the Province (if any).
Reporting Templates. Reference Title Description Reporting 1 Activity and performance report Lifeblood is required to provide reports to the NBA in accordance with the Deed and as specified in the NSR&S’. Reporting 2 Finance Report Reporting 3 Performance report to the COAG Health Council Reporting 4 Research and Development Annual Report Reporting 5 Research and development project proposals Reporting 6 Insurance report Reporting 7 Lifeblood Incident Report for the NMF purposes Reporting 8 Horizon Scanning Report Reporting 9 International Benchmarking Presentation Reporting 10 Business Plan Reporting 11 Strategic Plan Reporting 12 Risk Management Plan Reporting 13 Capital Plan Reporting 14 Supply Chain Loss Report Reporting 15 Transfusion Haemovigilance Report Reporting 16 AHP details and delivery schedule Reporting 17 Donor Haemovigilance Report Table 6: Data Set Templates Reference Title Description Data Set 1 eProgresa Issue Files for BloodNet Lifeblood is required to provide Data Sets to the NBA in accordance with the Deed and the NSR&Ss Data Set 2 IVIg STARS Data Data Set 3 Incident Data for NMF Data Set 4 National Inventory Report Fresh Components Data Set 5 Overseas Supply Report Data Set 6 IDMS Monthly Upload - Invoices Data Set 7 IDMS Monthly Upload - Supply Data Products 7a-7c Data Set 8 IDMS Monthly Upload - Warehouse Issuage Data Set 9 IDMS Monthly Upload - Stock Movements Data Set 10 IDMS Monthly Upload - Stock Counts Data Set 11 Monthly Plasma for Fractionation Data Set 12 Monthly Supply to States and Territories Data Set 13 Monthly receipts - Group 3 & 4 Products Data Set 14 Monthly 6 Month Forward Expiry - Group 3 & 4 Products Data Set 15 Lifeblood AHP Report Table 7: OBFM OBFM and Attachments OBFM Financial Years 2022-23 to 2024-25 The OBFM sets out the Payment obligations and principles agreed between the Parties for the provision of Products and Services provided by Lifeblood under and in accordance with the Scope of Activities as specified in the Deed and NSR&S 2. Attachment A Cost Attribution Rules and Lifeblood SOP Attachment B MPC Calculation Attachment C Invoice Format Attachment D Timetable Attachment E Terms of Reference for a Full Disclosure Audit Section C: Relation of Deed Clauses and Terms to the FSA Schedules Table 8: Deed Clauses Deed Clause Purpose FSA Schedule 2.1.4 Transition arrangements NSR&S 30 – Clinical Services Framework (to be transitioned) NSR&S 26 – Donor Management (to be transitioned, removed and replaced with NSR&S 42, 43 and 44)...
Reporting Templates. When reporting to the Province, the Municipality will use the templates provided by the Province (if any). Report Details
Reporting Templates. The reporting templates attached to this Schedule “F” are samples only. Unless HSC directs otherwise, the Service Manager must comply with the reporting formats and reporting requirements included. Those formats and requirements may vary from the attached reporting templates. Report Details
