Application Form

Clinical Practice Guideline Development & Implementation Grants

Please complete this application form in as much details as possible. It is a complex form requiring up to 10 minutes to complete, and you will need to supply supporting documentation. We recommend reviewing the form thoroughly prior to starting.

EASO Clinical Practice Guideline Grant Application

* Indicates a required field

Your Details

First Name(Required)

Last Name(Required)

Email(Required)

Organisation Details

Organisation Name(Required)

Organisation Address Line 1(Required)

Organisation Address Line 2

Organisation City(Required)

Organisation Postcode

Organisation Country(Required)

Organisation Phone Number(Required)

Organisation Website

What population does your organisation serve?(Required)

How is your organisation classified?(Required)

Is this organisation governed or managed by a board of directors, council or committee?(Required)

Yes

Please list the chair and any other key board members. Ensure you note any health care providers.(Required)

Contact information (contact name, email and phone number of person legally authorised to sign contract or letter of agreement)(Required)

Organisational description: Brief description of your organisation, e.g. history, whether it is non-profitable or not, overall purpose, geographic area of operation, members (if any), experience in obesity management (mandatory)(Required)

Country-specific context

Detailed description of the current situation in terms of clinical practice guideline development and implementation in your country.

Why does your country need to develop, adapt or implement clinical practice guidelines? Please describe your reasons for applying to the CPG grant (Maximum 300 words)(Required)

Who will benefit from your proposed CPG project?(Required)

How do you think the guideline project will benefit your stakeholders/members?(Required)

What outcomes do you expect from your proposed clinical practice guidelines project?(Required)

Organisational capabilities and resources

Brief description of past experiences with similar initiatives (if any), results/outcomes achieved.

Does your organisation have the human resources required to implement a guideline adaptation project? (Identify the project coordinator and their capacity to implement this project).(Required)

Does your organisation have the financial resources to implement this guideline project? Please provide a detailed budget and confirmation of funding from your local guideline development funders/grant providers.(Required)

Does your organisation have access and links to key stakeholders that can participate in the proposed guideline project (e.g. partnerships and collaborations with professional associations, engagement of patients living with obesity, collaborations with policymakers, obesity researchers, clinicians, independent methods experts, etc.)? Please provide letters of support or partnership letters from local organisations that will be involved in the adaptation process.(Required)

Letters upload

Drop files here or

Max. file size: 128 MB.

Does your organisation have data collection and storage procedures in place that comply with relevant data protection regulations?

Yes

Approach

Describe how you will undertake the guideline development, adaptation and/or dissemination/implementation process

If you are planning to adapt an existing guideline, please specify which adaptation methodology you will use. If you are planning to develop a new guideline, you should engage an independent methods expert team to guide the development of new recommendations. This may require additional funding and guideline adaptation teams should budget for this cost.(Required)

If you are planning to implement an existing guideline, a detailed supplementary plan needs to be included with the application (max. 2 pages).

Drop files here or

Max. file size: 128 MB.

How will you ensure the socio-cultural and linguistic accuracy of the guideline project?(Required)

Partners and collaborators

If there are partnerships with national organisations, please indicate the partnership organisations (e.g. Academic institutions, professional associations, patient advocacy organisations) explicitly(Required)

Please provide letters of support or partnership letters from local organisations that will be involved in the adaptation process.

Drop files here or

Max. file size: 128 MB.

Timeline

Please provide a detailed outline (e.g., Gantt chart) of planned activities, expected timeframes, and outcomes.(Required)

Supporting Documents

Drop files here or

Max. file size: 128 MB.

Further Information

Please provide any further information that you feel is relevant to support your application (Maximum 300 words)(Required)

Agreement

By submitting this application, I confirm that I have the authority to submit this request and agree to the conditions described below:(Required)

All information contained herein is true and accurate to the best of my knowledge.

Should EASO approve our application, I agree to submit a final report within 60 days of the project’s completion.

I have read the agreement above and agree to all the terms therein.

Education

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CPG

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About EASO

Application Form

Clinical Practice Guideline Development & Implementation Grants

Please complete this application form in as much details as possible. It is a complex form requiring up to 10 minutes to complete, and you will need to supply supporting documentation. We recommend reviewing the form thoroughly prior to starting.

EASO Clinical Practice Guideline Grant Application

Your Details

Organisation Details

Country-specific context

Organisational capabilities and resources

Approach

Partners and collaborators

Timeline

Further Information

Agreement