Health Policy Template

 

Follow this guide to write health policies for your program.

 

Belief Statement: A brief statement about why the center believes the policy is necessary.

Intent Statement: An explanation of the purpose of the policy.

Background: Why the policy was developed. Not every policy will have a background statement.

Procedure/Practice: Action necessary to accomplish what the policy recommends.

Applicable: To whom does the policy apply?

Communication: How are families/staff informed about the policy.

References: What information was used to develop the policy or procedure?

Review: Who reviews policies at the center?

Effective Date: When will the policy be put into effect?

Review Date: How often will the center review the policy?


Developed by Kathy Brownfield, RN, Med
Revised by Debbie Garrett, RN, MPH


If you need assistance with policy and procedure development please call Katie Brach, RN at 973-923-1433 x 141


For more information visit http://www.cdc.gov/health/default.htm

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