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How did you hear about these resources? *
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Options
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Lanyard / Pocket Card 1 - Assessment Tools Descriptions
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Lanyard / Pocket Card 2 - Guide for Responding to Assessments
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Lanyard / Pocket Card 3 - SAS Visual Aid
(for patients, families, staff)
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Source:
PCOC Assessment and Response Protocol
Talking about your symptoms
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Please choose either Section 1 (complete set) or Section 2 (individual) to order resources *
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There are two sections for ordering resources, with only one section requiring completion:
1. Complete set of resources – equal numbers of each of the resources;
OR
2. Individual resources – when only 1 or 2 (not all) resources; or if different numbers of each resource are required, e.g.:
- Lanyard/Pocket Cards 1 &/or 2: indicate number required in the order box/es for each of these resources, as required;
- Lanyard/Pocket Card 3: indicate number required in the order box for this resource.
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1. Resource Set
Lanyard/Pocket Card 1 - Assessment Tool Descriptions
Lanyard/Pocket Card 2 - Guide for Responding to Assessments
** Lanyard/Pocket Card 3 - SAS Visual Aid (for patients, families, staff)
** Small rulers (170mm × 65mm) are provided as standard.
If you require Large rulers (225mm × 95mm, max. 10 per order), please select and enter the required quantity.”
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Select SAS Visual Aid size *
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2. Individual Resources
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** Small rulers (170mm x 65mm) are provided as standard.
If you require Large rulers (225mm x 95mm, max 10 per order), please select and enter the required quantity
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Select SAS Visual Aid size *
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Data collection statement
The information you provide on this form will be used by PCOC to fulfil your order. The data will be stored in electronic format on a secure password-protected server located in a physically secure computer room at the University of Wollongong.
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