Booking Form

ATSSL Booking Form


This form is designed to be used for all ATSSL Booking Inquiries and Requests.

Based on the answers you provide additional form fields will be displayed as applicable. All displayed fields are required in order for your booking to be completed, to avoid the cancellation of your booking any information omitted from your initial booking needs to be submitted at least 2 weeks prior to your requested session.

Please note the completing an ATSSL Booking is a multi-step process - refer to the Booking Policies and Procedures for full details

Completing this form initiates the process, and will result in a 'hold' being placed for the requested space and equipment, if available, pending the completion of all required steps.

Have ATSSL resources been requested for past iterations of this event?
Which of the following best describes this event?
This submission can be in the pre-submission stage
Are you the Principal Investigator (PI) for this project?

Are you the educational lead for this event?

ATSSL Criteria for Educational Leads:

  • A Practicing Healthcare Professional
    WITH
  • An Academic Appointment with the CSM or a Clinical role with AHS
    AND
  • Is available to attend the entire session
    AND
  • Is Responsible to approving the finalized curriculum


What is your primary affiliation
Which UCalgary department is this session for
Please indicate the training program(s) of participating residents



How many sessions would you like to book for this event
Will all sessions have the same start and end times?
Please describe the activities participants will be involved in. Please include the learning objectives if available.
Please also include some target dates in your description

Please indicate which of the Patient Safety Competencies will be addressed during this event:
A commitment to applying core patient safety knowledge, skills and attitudes to everyday work.
Working within interprofessional teams to optimize patient safety and quality of care.
Promoting patient safety through effective health care communication.
Anticipating, recognizing and managing situations that place patients at risk.
Managing the relationship between individual and environmental characteristics in order to optimize patient safety.
Recognizing the occurrence of an adverse event or close call and responding effectively to mitigate harm to the patient, ensure disclosure, and prevent recurrence.
Please indicate which CanMEDS Competencies will be addressed during this event:
How does this learning opportunity align with your current educational curriculum?
x
Summary of Needs Assessment results
Please indicate which methods were utilized for the needs assessment. If other methods used, please specify
Please indicated what sources were used for the needs assessment. If other sources used, please specify.
Mimimum Required Learning Objective Elements: 1) Who; 2) Will do; 3) How well/How much 4) Of what 5) By when; 6) In what context
How will you know if this event successfully addressed the intended learning objectives? 
If already developed please upload a copy of your evaluation form in the Supporting Documents section at the end of this form.

Will learners be charged a fee to participate in this event?


Please upload any supporting documents for your equipment request. 
Maximum 3 files.
100 MB limit.
Allowed types: jpg, txt, pdf, doc, docx, xls, xlsx, .

Will learners be charged a fee to participate in this event?
Is any industry support being provided for this event?
Is any industry support being provided for this event?
Will this event be catered?
Please indicate which of the following will be used for covering any costs incurred by your request?
Will you require an estimate for the fees associated with this request?
Please attach any applicable supporting documentats for the booking.
i.e. Draft Agenda; Reseach Proposal; Curriculum Development Documents
Maximum 5 files.
100 MB limit.
Allowed types: gif, jpg, jpeg, png, bmp, eps, tif, pict, psd, txt, rtf, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, mp3.
CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

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