STRENGTHENING THE PROCESS OF HEALTH CARE AGENCY

STRENGTHENING THE PROCESS OF HEALTH CARE AGENCY:
CITIZEN TO CITIZEN

THE PROJECT PACKET INCLUDES:

Executive Summary, a brief overview of the project report, available for ?promotional? distribution.

Facilitator Training Manual, a detailed step-by-step guide to conducting a twenty-hour trainee/facilitator training program. Upon completion of training program, facilitators will then be prepared to conduct a one-hour community educational forum. Appendices with sample materials for use in implementing the program are included.

Training Videos: 1) a twenty-six minute video of three vignettes illustrating the models of principal-agent relationships, to be used in conjunction with the training manual and for the one-hour community educational forum; and 2) a nine-minute synopsis of the twenty-six minute video.

COST: $150-Entire Packet; $75-Training Videos only (includes shipping and handling)

The NEW YORK CITIZENS COMMITTEE ON HEALTH CARE DECISIONS, INC. (NYCCHCD) is a non-profit, non-partisan grassroots initiative providing an impartial forum for public discussion of critical health care issues. The Committee?s goal is to heighten public and professional understanding of these issues and to foster informed participation in both individual care and the formation of public policy. The Committee has no hidden agenda; we seek only to raise issues and explore options.

STRENGTHENING THE PROCESS OF HEALTH CARE AGENCY: CITIZEN TO CITIZEN was an eighteen-month project funded by the Fan Fox and Leslie R. Samuels Foundation. The ultimate purpose of this project was to insure and protect individuals? rights to a controlling interest and participation in making end-of-life medical decisions reflecting their concerns, wishes, values regarding critical medical treatment and care.

ORDER FORM

Please send _____ packet(s) @ $150/packet
of Strengthening the Process of Health Care Agency:
Citizen to Citizen.

Please send _____ set(s) of Training Videos @ $75/set.
Name:_____________________________________
Organization:________________________________
__________________________________________
Address:___________________________________
City:______________________________________
State/Zip: __________________________________
Phone: (_______)____________________________

Enclosed is a check payable to
NYCCHCD for $__________.

Mail this form to:
New York Citizens? Committee on
Health Care Decisions, Inc.
39 Broadway, Suite 200
New York, NY 10006

____Please send me additional information
about the New York Citizens Committee
on Health Care Decisions, Inc.

Tel: 212-586-4638
Fax: 212-586-4699