FASD Work Plan

Improving Fetal Alcohol Spectrum Disorders Prevention and Practice through Practice and Implementation Centers and National Partnerships

I4 Pediatric FASD Regional Education and Awareness Liaisons Work Plan

OMB: 0920-1129

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Form Approved
OMB No. 0902-XXXX
Exp.: XX/XX/20XX

Fetal Alcohol Spectrum Disorders
Regional Education and Awareness Liaisons

Improving health outcomes for infants and children diagnosed with one of the FASDs
by addressing stigma and bias and increasing early identification.



Name: ______________________________________________________________________ Date: ________________

Region: ____________________________________________



As the FASD champion for Region ____ of the American Academy of Pediatrics (AAP), I will take part in the following activities to support issues related to FASD during 2016:

FASD Champion Metric: FASD Champions will submit a work plan including specific aims and measures for achieving progress. At the end of the year, FASD Champions will provide a written summary/update on progress made towards work plan activities.

2016 Work Plan Submission Date:



FASD Champion Metric: FASD Champions will participate on Regional Network trainings/conference calls/webinars 1 times per year.

Dates:


1. _______________________________ Attended Yes ⎕ No ⎕

Details on method, mode and frequency of contact and planned collaborative efforts:


Other Person(s) Involved:



FASD Champion Metric: FASD Champions will educate pediatric clinicians in their respective regions regarding FASD.

Activity 1:
Date:
Audience:

Person(s) Involved:

Activity Details:




Activity 2:
Date:
Audience:

Person(s) Involved:

Activity Details:


*More activities can be listed on the back of this page as necessary


Other FASD Champion Activities.

Activity:
Date:
Person(s) Involved:

Activity Details:



Activity:
Date:
Person(s) Involved:

Activity Details:



Activity:
Date:
Person(s) Involved:

Activity Details:





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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorFaiza Khan
File Modified0000-00-00
File Created2021-08-14

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