African Palliative Care Association :: permission form

APCA Members

LOG IN

Not registered?

Forgot Your Password?

Incorrect login or password

SIGN UP

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

* Title of article / book / programme:

* To be published / produced by:

* Date of publication / production:

* Anticipated print run:

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

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’.
Make no changes (be that additions or deletions) to the tool
Permission shall only apply to the work specified above. A new application must be made for any additional works.
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

* Title of study / audit:

* Name of funding agency:

* Country/ies within which study is to be conducted:

C. Contact details

* Name of lead author / Principal Investigator (PI):

*Full work address of lead author / PI:

* Country:

* Email:

* Tel:

* Fax:

Copyrights © 2023 African Palliative Care Association. All Rights Reserved.

Site by KAINGroup