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Example Submission Form

(Brief description of practice)
(What are key lessons learned from the design and implementation, innovations, or other features of this practice that would help others in their work?)
(Please specify)
(Approximate costs including year and units)
(Number of individuals served and number of locations implementing)
(If this practice has been evaluated and information is available, or an evaluation is underway or planned, please complete the Evaluation References section; if not, please go to Contact Information.)
(maximum size: 5 MB) (accepted file types: .doc .pdf)
Contact Information

By submitting contact information and details of your practice you agree to be contacted by the evaluation team, and to possible publication of the same information. Given contact details will be published on the EPIC website.