Region Jnkpings ln Qulturum
plus.rjl.se/qulturum

Inquiry of Study Visit/Co-Learning

Prior to your planned study visit at Qulturum, we would like you to answer the questions below.
Your answers are helpful in the planning process of your visit. They will give us the opportunity to focus on your main areas of interest, but also at what we can learn from your visit for future collaboration and exchange.

At Qulturum we receive many inquiries about study visits, this means that a lot of time is spent on planning and organising. In order to make these visits reasonable for us and give you, as visitor, interesting and giving hours at Qulturum, we have to charge you a fee that includes coffee, lunch, lectures and localities. Hopefully this is understandable.

This inquiry will be regarded as a preliminary request, until you receive a confirmation from Qulturum.

*= Required

 Contact Information
Visiting group/workplace*:
Date for visit at Qulturum: From (yymmdd):
  To (yymmdd):
Your contact person  
Name*:
Job title*:
E-mail address*:
Organisation  
Name*:
Invoice address*:
 Participants
Name*: Job Title*: E-mail address*: Special diet/Food allergies*:
Study visit specifications

Main areas of interest?:

 Patient Safety

 Patient Involvement

 Leadership

 Prevention

 Primary Care

 

Information about you

What is the cause of your visit?*:

How did you find out about Qulturum?*:

What resources do you have for improvement work?*:



In what way do you work with leadership and management?*:


 
Which are your most important improvement projects?*:

 

Do you have any reports or documentation of your improvement work?*:

 

Which improvement work are you most proud of?*:

 

Why do you believe coming to us is worthwhile?*:

 

How can we continue to network after your visit?*:

Further comments?:

 

 

Uppdaterad: 2018-10-11
Rebecka Berger, Qulturum, RLK o Verksamhetsnära funktion