• Download Check List Form
  

Getting Started

• Complete the Distribution Agency Agreement and return it to your Site Director.
• Have your staff complete the Confidentiality Agreement as necessary. Return these to your Site Director.
• Complete your site’s required human subjects protection training. This varies by site, so please check with your Site Director to determine the appropriate training for your area.
• Order your supplies. This includes the educational brochure, posters, pacifiers, forms and surveys.
• Verify your site’s program eligibility requirements. Specific qualifications vary by site, so please check with your Site Director to determine your site’s specific requirements.

With Your Crib Recipients

• Complete the Crib Recipient Background form. This is an optional form that you can use to collect information on your recipients. If you already have a system for capturing this information, you do not need to use this form.
• On a monthly basis, you will enter this information into First Candle’s database (see below).
• Discuss the Crib Receipt, Release and Waiver of Liability form with the recipient.
• Have the recipient sign the Crib Receipt, Release and Waiver of Liability form. (He/she must sign this form to receive a portable crib.)
• Discuss the evaluation and Informed Consent.
• Have the recipient sign the Informed Consent form.
• Administer the Pre-Survey.
• Provide education to the recipient. This may include showing the recipient the video, providing a trainer who can educate the recipient and providing the written educational materials.
• Provide the Bedtime Basics Kit and a pacifier to the recipient. Please note that the wearable blanket is contained inside the carton.
• Follow-up (within 2-3 months) to complete either the Post-Survey or the Home Visit Survey.

On a Monthly Basis

• Submit the following materials to your Site Director: signed Crib Receipt, Release and Waiver of Liability forms for all participants who have received a portable crib.
• Signed Informed Consent Forms and all completed surveys for all evaluation participants.
• Complete the two monthly reports online: Crib Distribution Report & Program Activities Report.

Last Updated: Sep 13, 2010