CSHP Student Chapter Community Service Project Award
Reporting Guidelines
Patient care projects will be judged based on a cumulative event report. Events may be conducted at any
time throughout the calendar year (January 1 – December 31). Student Chapters must use the following
reporting guidelines to participate in this award program. These guidelines outline how the chapter should
write its report on the project(s) implemented during Asthma Education, Tobacco Cessation, and Poison
Prevention Awareness. The report should also include examples of unique supporting materials from the
individual project(s). The supporting materials may include include photos, news releases, and/or articles.
The following sections should be included in the report (Appendix):
Section I: Student Chapter Contact Information
Section II: Essay
Section III: Chronological List of Events
Section IV: Patient Care Project Report Form
Section V: Report Submission Confirmation and Chapter Advisor Signature
Reports must adhere to the following format:
 Double-spaced, 10-point, Times New Roman font, with 1” margins (left and right).
 The header of each report must be centered and contain the Student Chapter’s Name (first line)
and the Report Name (second line).
 The end of the report essay must contain word count.
 The footer of each page must contain Page X of Y.
 Files must be labeled as “Student Chapter Name Poison Prevention .pdf”.
Supporting materials may include:
1) Photographs
Photographs must be submitted electronically to PICASA and must be labeled “Student Chapter
Name patient care project Pic #.jpg” (i.e. “UCSF Poison Pic 1.jpg” or “USC Asthma Pic 2.jpg”).
Once photographs have been submitted electronically to CSHP, the organization reserves the
right to use these photographs in CSHP publications, marketing materials, and during CSHP
meetings.
2) Original Documents/Materials
Additional supporting materials developed by the student chapter (original documents/materials
only) may be included to illustrate the activities described in the essay. All supporting materials
must be emailed with the original report. No more than five (5) documents will be accepted.
CSHP Student Chapter Community Service Project Award
Section I: Student Chapter Contact Information
1) School or college of pharmacy name and address
2) CSHP chapter president name and email address
3) CSHP chapter advisor name and email address
4) Patient care project student coordinator(s) and email address(es)
Section II: Essay
Please describe the planning, implementation, and outcomes of your chapter’s activities, specifically
highlighting the significance of your accomplishments, and how they affected your chapter members,
community, and/or the profession of pharmacy. Please do not list dates of events, activities, and
programming, as this is already covered under the chronological list.
Information provided in the essay may include, but is not limited to:

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Planning
o Committee structure indicating chair, vice chair and members
o Your chapter’s Goals and Objectives for targeting the public through the community
service project campaign
o A description of the planning process and steps taken to achieve goals and
objectives
Implementation
o A description of the promotion of the campaign, including media coverage and
materials unique to your campaign
o A description of your chapter’s collaboration with the community and other
professional health care organizations for your campaign
o A description of what made your campaign innovative or unique
Outcomes
o Describe the impact your project had on student pharmacists, the profession of
pharmacy, and most importantly the public you served
o Describe how your chapter achieved its goals and any possible improvements that
could be made for next year
Patient care project report essays may not exceed 1500 words. If your essay exceeds 1500 words,
only the first 1500 will be submitted to the Awards Selection Committee. A final word count is required at
the end of the report essay.
Section III: Chronological List of Events
Activity Name Date
Location
# students
present
# patients
educated
Event Synopsis (<50 words)
CSHP Student Chapter Community Service Project Award
Section IV: Community Service Project Report Form
List the patient outreach results of your patient care project campaign.






Total number of patients at all presentations/events.
Total number of patients screened (if applicable).
Total number of patients reached through PR initiatives (e.g. educational materials).
Total number of student pharmacists involved in all events.
Total number of faculty involved in all events.
Total number of non-faculty pharmacists involved in all events.
Section V: Report Submission Confirmation and Chapter Advisor Signature
Please submit this form electronically to CSHP along with your chapter’s report(s).
Submission Checklist
Please indicate which of the following reports have been submitted for adjudication. This form only needs
to be submitted once.
Asthma Education
Pictures (#: ___)
Supplemental Material (#: ___)
Tobacco Cessation
Pictures
Supplemental Material (#: ___)
Poison Prevention Awareness (#: ___)
Pictures (#: ___)
Supplemental Material (#: ___)
Chapter Advisor Confirmation
“As the Student Chapter Advisor, I hereby state that the following materials are the work of our Student
Chapter’s Members and the activities represented in this entry are an accurate portrayal of the work the
Student Chapter has completed.”
CSHP Student Chapter: ______________________________________ (print name)
Signature of Student Chapter Advisor: ___________________________
Date: ___________
DEADLINE: Entries must be submitted to CSHP no later than 5 PM Pacific Time on June 1. Please
see the Student Chapter Patient Care Project Award Reporting Guide for submission instructions.