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APCA African Palliative Outcome Scale:
  Permission Form to Reproduce / Use

Please complete either section A or B, and your contact details in Section C, and email a scanned version to info@africanpalliativecare.org

A. Permission to reproduce

Permission is granted to reproduce the APCA African Palliative Outcome Scale (POS) subject to the following stipulations:

  1. Refer to the tool as the ‘African Palliative Care Association’s (APCA) African Palliative Outcome Scale (POS)’ on first use, and subsequently as the ‘APCA African POS’.
  2. Make no changes (be that additions or deletions) to the tool
  3. Permission shall only apply to the work specified above. A new application must be made for any additional works.
  4. The validation article to be cited is: Powell RA, Downing J, Harding R, Mwangi-Powell F & Connor S on behalf of the APCA M&E Group (2007) Development of the APCA African Palliative Outcome Scale. Journal of Pain and Symptom Management, 33: 229-232

B. Permission to use

C. Contact details