NATSAP Research Designated Program Initial/Renewal Form

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This is the official application for NATSAP member programs applying for the research designated program endorsement.

If this is your INITIAL APPLICATION, please refer to the 6 MONTHS PRIOR to the date of submission.

If this is a RENEWAL APPLICATION, please refer to the 6 MONTHS PRIOR to the date of submission

Levels Definitions:

Bronze= 70% of Admit census sampled
Silver= Bronze + 70% of discharge data
Gold= Silver + 25% of 6 &12 months post discharge data

Program name

Primary contact

Primary contact phone number

Primary contact email address

This is my: *

Initial application

Renewal application

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