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Shared Decision Making Toolbox Documents (Internal)

IRB Application Materials

UW Certificate of Exemption Application #36581

UW Certificate of Exemption Clarifying Answers

Human Subjects Application (Group Health)

Boilerplate language (FIMDM)

Consent Forms

These forms are not necessary unless your institution requires written consent. Most of the cover letter examples below include implied consent language.

Consent form example (White River Junction VA)

Consent form example (Dartmouth-Hitchcock Medical Center)

DA Distribution Cover Letters

This section includes cover letter examples from which to choose. The Check-box Return Sheet is optional. The Research Info Sheet is also optional, and is not needed if your institution classifies the SDM demonstration as exempt / quality improvement.

Ex 1: Intro Cover Letter (Carol Milgard Breast Center)

Ex 2: Intro Cover Letter (Everett)

Ex 3: Intro Cover Letter (UW/GH)

Ex 4: Intro Cover Letter (UW/DHMC)

Ex 5: Intro Insert, 3 per page (Group Health)

Ex 6: Check-box Return Sheet (UW/DHMC)

Ex 7: Research Info Sheet (UW/DHMC)

Workflow Mapping

Workflow Mapping - Breast Cancer (VMMC)

Workflow Mapping - Breast Cancer (GH)

Workflow Mapping - Cardiology (GH)

Workflow Mapping - General (MultiCare)

Workflow Mapping - General (DHMC)

Workflow Mapping - General (Pioneer Memorial Clinic, OR)

Workflow Mapping - Orthopedics (Everett)

Workflow Mapping - Orthopedics (GH)

Workflow Mapping - Knee Osteo Baseline Map (DHMC)

Workflow Mapping - Hip & Knee Osteo Revised Map (DHMC)

Workflow Mapping - Women's Health (GH)

Communication Materials

Flyer in Waiting Room (MultiCare)

"What are the Providers Saying?" 4-minute video (FIMDM)

Shared Decision Making FAQs (Everett)

Introduction to SDM & DAs (UW/Col)

Letter to patient of a network provider (GH)

Letter to provider re patient receiving DA (GH)

Phone script to follow up on DA distribution (GH)

Project Background

SDM Demonstration Backgrounder (UW)

Overview of Questionnaires (UW/DHMC)