APhA Foundation Incentive Grant Program
Final Report

General Information

First Name: *

Last Name: *

E-mail address: *

Practice Site Name: *

Please describe the services delivered at your practice setting (please check all that apply) *

Project Title *

Has the funding for the project been sufficient for you to complete your work? *

Please provide a document that details how the funds provided by the APhA Foundation were used in your project. (.pdf, .doc, or .xls) *

Please provide an abstract or brief description of your project: *

Please summarize the results of the project: *

Please describe how patients and other health care providers responded to the services offered through this project: *

Please describe your most memorable patient experience related to this project: *

Please describe any changes/adjustments/improvements made to the original plan or budget: *

Have you submitted or do you intend to submit a manuscript for publication in a journal? *

Yes

No

If yes, please provide the name of the journal.

Please upload any supplemental materials that could assist the APhA Foundation in evaluating the impact of your project.