QHII/HWR project participation form — fax to 301-320-0978

• Please copy this form and give it to colleagues/members
• For more information, please contact Awards Coordinator at 301-320-0971 or by email to hii@hii.org

Name: ___________________________________________________________________

Title: ____________________________________________________________________

Institution: ________________________________________________________________

Address: _________________________________________________________________

________________________________________________________________________

City/state: __________________________________ ZIP ___________________________

Tel: __________________________ Fax: _______________________________________

Email: ____________________________________________________________________

I'm interested in — please check all that apply

Serving on the QHII Project Advisory Board; HWR Project Advisory Committee
Nominating heros and zeros — health-oriented websites that have consumer-friendly and/or consumer-unfriendly features
Compiling existing/suggested criteria for rating health-oriented websites
Evaluating/formulating criteria for rating health-oriented websites
Developing worksheets to apply criteria for rating health-oriented websites
Testing worksheets/criteria for rating health-oriented websites
Selecting assessors/evaluators (to assess health-oriented websites)
Nominating website
Assessing/evaluating health-oriented websites
Assessing/evaluating methods used by organizations to rate health-oriented websites
Creating consumer-friendly disclosure templates for use by webmasters
Sponsoring the QHII/HWR project
Designing workshops on subjects related to QHII
Attending workshops on subjects related to QHII
Being kept informed of progress
Nominating colleagues who would welcome being informed about QHII/HWR project— please attach colleagues' contact information!
Participating in some other way — please specify below

Remarks/requests — please write below or attach sheet.