Proposal Recommendation
Please submit this form with any recommendation for Higher
Education Emergency Relief Funding (HEERF).
Proposals should identify clear goals, objectives, and quantifiable
metrics. There are strict federal guidelines on
how HEERF funds can be utilized. More information can be found on
the U.S. Department of Education HEERF
Funding main page, along with an extensive FAQ here.
Proposals that are determined to be an allowable use in accordance
with the United States
Department of Education guidelines will be made available to the
college community for
comment. Submission of proposals does not guarantee approval or
appropriation.
Proposal Title:
Was this part of your departmental budget prior to COVID-19?
If yes, how much was allocated for this purpose?
There are five main categories, and your proposal must fall under
one of the following. Please choose
which category your proposal falls under:
Please explain how your proposal fulfills the purpose of the
category you selected, what the
current barrier is, why this proposal is needed to address that
barrier, and how this proposal
furthers the college’s goal of creating a more equitable
institution.
Proposal Description (Attach additional documents above as
needed):
Office of the Controller
DocuSign Envelope ID: 6984A501-8284-49CB-BD97-32B910134DB2
Lori Martone-Roberts
Students are experiencing a gap in their clinical skills because of
the pandemic and the requirements for social distancing. Currently,
there
are limited skills lab and clinical time available to students and
this is negatively impacting their ability to practice and master
essential
nursing skills as they normally would pre-COVID. With these Modular
Skills Trainers, students are able to adequately learn clinical
skills
remotely in their home and/or socially distanced in the laboratory
on their own individual skills trainer. This reduces the equity gap
for
students who need to quarantine, cannot travel to campus, or are
financially unable to purchase alternative supplies.
Professor
Yes
Nursing
N/A
See attached quote from Laerdal for the Modular Skills Trainer 2
for 185 portable skills trainers of a variety of diverse patient
demographics. It
is requested that each student from the Spring 2022 ADN incoming
class have access to a trainer that can be used throughout the
program as
a way to address the current limitations of learning essential
nursing skills remotely with alternative supplies such as play-doh,
construction
paper, and cardboard that was regularly used during the beginning
of the pandemic. The remaining skills trainers in the quote will
be
disbursed evenly throughout all of the nursing skills laboratories
to account for social distancing requirements. These lab trainers
can be
loaned out to faculty and students as needed and properly
disinfected when returned.
Equipment for Remote Nursing Skills Lab
Please explain how the proposal aligns with one (or more) of the
goals outlined
in the Strategic Plan.
Goal 2: Expanding Partnerships and Programs
Goal 3: Strengthening Institutional Effectiveness
Please outline quantifiable metrics of this proposal:
How will this proposal be sustained after the HEERF funding
period?
For Administrative Purposes Only
HEERF Funding Alternative Funding
DocuSign Envelope ID: 6984A501-8284-49CB-BD97-32B910134DB2
With proper maintenance, these trainers used within the laboratory
should be functional for several years which allows for the
nursing
students to have consistent access to them in the laboratory and
for loaning purposes. Ideally, incoming students in the Fall 2022
will not have
the same restrictions due to the pandemic, however, we may consider
adding this to the student required book/supply orders to
allow
financial aid to cover the expense for qualifying students.
This proposal aligns with the college's strategic plan by promoting
student success and completion through technoloigical advancements
and
remote learning. These trainers allow students to work
independently and intraprofessionally in a mobile, adaptable
learning environment.
As an institution, we have access to the curriculum integration
guide for the modular skills trainers developed by the National
League for
Nursing in partnership with Laerdal Medical.
X
The Nursing Department has collected metrics on the students who
were enrolled in Nursing during the beginning of the pandemic
which
indicates a gap in essential nursing skills. The faculty has also
qualitatively measured students within labs and clinicals and have
noted this
particular necessary area of improvement. Students will continue to
be monitored and metrics will be collected. It is the goal of this
proposal
to positively impact the student's nursing skill level for
successful program completion.
X
X
X
11/10/2021 | 3:53 PM EST HEERF FAQ Question #32 - Institutions may
use the funds to purchase equipment
or software... to enable students to transition to DL as such costs
are associated
with a significant change in delivery of instruction due to
COVID.
Allowable cost 11/12/2021 | 7:21 AM PST
X
National League for Nursing
DocuSign Envelope ID: 6984A501-8284-49CB-BD97-32B910134DB2
Teaching Strategies 7
DocuSign Envelope ID: 6984A501-8284-49CB-BD97-32B910134DB2
Introduction
3
The teaching and learning of essential nursing skills is critical
whether learners are engaged in remote learning or face to face
content delivery methods.
The Laerdal Modular Skills Trainer provides faculty and students
opportunity to watch, practice, and engage in assessment of skills
attainment. This guide is intended to provide some ideas for
faculty on how they might make use of the skills trainer to advance
students through the curriculum. The trainer allows manipulation of
realistic equipment and supplies in combination with screen-based
learning that is similar to lab or classroom modalities.
Skills covered with the Modular Skills Trainer:
• Nasogastric tube insertion
4
For practicing the skills, learners must also have the appropriate
supplies available for practice. Since these vary between
institutions and vendors, it is suggested to obtain or prepare
supply kits to align with the skills trainer.
The User Guide provided by Laerdal Medical describes the assembly
and suggested use of the various modules for successful completion
of each skill.
Included Parts and Accessories
• Wound pad
• Injection pad
• Ostomy site
• Carry bag
5
The Modular Skills Trainer is intended to be used in conjunction
with the training or curriculum already developed at your
institution.
The trainer allows demonstrations to be provided either in a
socially distanced lab or classroom, or online using current remote
teaching methods. Suggested integration methods include either
providing students with the Modular Skills Trainer for use
throughout their program, or having a supply of trainers that can
be checked out for additional self or instructor guided-practice
when skills are taught.
The advantage of having the skills trainer at home is that students
are able to practice in a comfortable environment. Initially
students will use the instructions provided on how to adapt to the
size, shape, and other attributes of the device. They can then
practice multiple skills as often as needed to maintain
competence.
The device is designed to be durable for repeated practice, which
is helpful if skills are taught over multiple courses and terms.
Clinical faculty may also find it helpful to have a skills trainer
available in a clinical site for just-in-time practice prior to the
performance of a skill.
The initial teaching and learning of psychomotor skills is only the
first step in skills acquisition. When there is a delay of weeks or
months between the learning of a skill and the opportunity to
repeat it, learners may not remember the process and skills decay
occurs. Retention of skill is a problem when skills are taught,
practiced, and evaluated early in a course or program.
Gonzalez and Kardong-Edgren (2017) have defined a process of
deliberate practice that can mitigate this problem. This process
does not mean that the learner only practices in isolation. Rather,
they state “A large body of research suggests that DP (deliberate
practice) in a controlled setting can help identify mediating
mechanisms that may produce superior skill performance and
retention, such as ‘think aloud,’ motivation, and performance
monitoring, and that accumulated amounts of DP are related to
attained levels of performance.” (p. 11.)
Individual learners may wish to practice alone in a private setting
as well, and Oermann, Muckler, and Morgan (2016) believe that “Not
all practice sessions need to be planned by the teacher. Although
experts should guide performance during initial learning to reduce
errors, students then can practice on their own.” (p. 280).
Keeping this in mind, students can practice on their own with the
trainer, and have access to the trainer for periodic supervised
skills reviews with feedback either in person or using a
screen-based method.
DocuSign Envelope ID: 6984A501-8284-49CB-BD97-32B910134DB2
Preparing Students for Use
6
Similar to simulation, students should be directed to perform a
skill as if they were in a live patient situation when using the
skills trainer. Before faculty expect students to perform the
skills, it is recommended that faculty also familiarize themselves
with the Modular Skills Trainer. Being familiar with the device,
allows faculty to provide any specific tips related to preparing
and positioning it for best results. It is also advised to orient
students to the trainer and the expectations for its use. Just as
prebriefing
is recommended prior to simulation, the same practice is useful
when incorporating the Modular Skills Trainer. This is done by
explaining to students that, while we know the Modular Skills
Trainer is not an exact replica of the human body, it is meant to
be a helpful training tool to allow for repeated skill practice and
retention. Additionally, faculty should provide respectful
communication and treatment of the tool as expected in an actual
patient situation.
DocuSign Envelope ID: 6984A501-8284-49CB-BD97-32B910134DB2
7
Depending on current isolation precautions and course delivery
methods, there are a number of strategies for using the Modular
Skills Trainer. Here are some suggestions for use, which can be
expanded upon as needed by innovative faculty and students.
• Skills assessment - The Modular Skills Trainer can be used for
skills assessment in addition to practice. From a student
perspective, it is preferable to practice on the skills trainer
first, rather than being introduced to the product in a “checkoff ”
situation. Assessment can then be completed either live in a lab or
classroom, or via remote video. Students may also complete
peer-to-peer review with consideration given to the competence of
the student doing the review.
• Embedding the skill into a patient case study – Begin by giving
the student an SBAR of a patient case. Prior to beginning the
skill, students are asked how they would adapt the skill for this
patient, considering age, diagnosis, current condition, family
presence, or other details.
• Exploring concepts within the skill in context such as sterile
technique – Prepare questions for each skill that encourage
students to explain their rationale and the knowledge guiding their
thinking and critical elements of each skill.
• Hybrid use of the Modular Skills Trainer with existing simulation
scenarios – This may be done in lab if students are practicing in
person, or via remote learning if simulations are being done
through video conferencing. A simulated patient/actor can provide
the communication portion of the scenario. At the point where a
skill is required, students can turn to their own skills trainer
and perform the necessary skill without needing to have direct
contact with the simulated patient/actor.
• Student remediation – If a student has failed to perform a
procedure skillfully in lab or clinical, the Modular Skills Trainer
can be available for repeated guided practice until the student is
comfortable and competent with the skill.
• Global health considerations – In situations where faculty or
students are traveling to other settings to provide patient care or
train health care providers in areas where supplies and equipment
are limited, the Modular Skills Trainer is an affordable teaching
device. It can be used during the visit and left behind so learners
in low resource settings can continue to have access to skill
practice.
DocuSign Envelope ID: 6984A501-8284-49CB-BD97-32B910134DB2
8
NASOGASTRIC TUBE INSERTION
Students can be presented with a simple case that involves only a
short description of a patient and a pre-op order.
*Mrs. Bates is a 60-year-old woman who is having a colon resection
for colon cancer. Her pre-op order states “Insert a 14 french
nasogastric tube.” Mrs. Bates is apprehensive about the surgery and
the procedure. She is alone since no family visits are currently
allowed due to isolation policies.
In this case students would be expected to perform the skill and
support the patient in the process.
Critical Thinking Questions:
• What is the rationale for placing the nasogastric tube?
• How will you respond if Mrs. Bates asks whether this will be
painful?
• What supplies will you need to obtain before beginning the
procedure?”
WOUND CARE (OPEN WOUND)
An example of a more complex case requiring skill
performance.
*Jonathan McAdams is an obese 20-year-old man who had surgery 10
days ago for a perforated appendix. He was sent home with supplies
and instructions to change the dressing daily. He had been noticing
increasing redness and purulent drainage at the incision site on
his abdomen and was readmitted yesterday. The wound was opened,
drained, and packed with saline dressings. You are to remove his
old dressing, clean the wound, and place a new dressing on
it.
Considerations for this scenario:
If working remotely with the skills trainer, students would need to
first dress the wound, then practice removing that dressing so that
they could replace it.
Critical Thinking Questions:
• What risk factors does this patient have for wound
infections?
• What other treatments will he likely be receiving for his wound
infection?
• What kind of discharge teaching will you do with this
patient?
Patient examples are listed below.
For programs using vSim® for Nursing or other virtual cases,
faculty can integrate the Modular Skills Trainer when virtual
simulated cases require skill performance. A vSim® for Nursing
scenario can be paused at the appropriate point while the student
performed the skill on the trainer.
This way, students are engaging both high level cognitive skills as
well as technical skills. The trainer can also be integrated with
any scenarios currently being used in clinical coursework.
DocuSign Envelope ID: 6984A501-8284-49CB-BD97-32B910134DB2
TRACHEOSTOMY CARE
*Finley Clark is a 5-month old male who was born prematurely at 29
weeks gestation. Finley has been in the NICU since birth and is
ventilator-dependent. His tracheostomy was done at age 3 months due
to the need for prolonged ventilatory support. Finley is due for
tracheostomy care and you will need to change the ties.
Considerations for this scenario:
This case can be made more complex in multiple ways. The patient’s
family may be present and students will need to teach them the
procedure. The patient can require suctioning before or after the
procedure is done.
Critical Thinking Questions:
• Is this a clean or a sterile procedure? Share your
rationale.
• What challenges does the patient’s age present during the
procedure?
• What are your main safety concerns?
CENTRAL LINE DRESSING CHANGE
*Faisal Khaled is a 60-year-old male who is in the ICU
post-surgical resection of a liver tumor. He had a central line
placed in the left subclavian vein 7 days ago, and is due for a
central line dressing change. Mr. Khaled has a transparent dressing
over the site. He is alert and communicating with caregivers.
Considerations for this scenario:
Faculty will need to keep in mind that, in order for students to
perform a central line dressing change, they will first need to
have a central line in place in the skills trainer, with a dressing
over the site. Whether this is done by skills faculty prior to the
students’ practice, or students will be setting up the central line
in the patient prior to the dressing change will need to be
determined in advance.
Critical Thinking Questions:
• What is the rationale for doing dressing changes every 7 days in
this patient? When and why might you change this schedule?
• List the equipment you will need to obtain prior to the
procedure.
• What signs would concern you related to a potential infection at
this site?
• What steps would you take if you noted any of these signs?
• What steps are you taking to prevent central line–associated
bloodstream infections, or CLABSIs?
DocuSign Envelope ID: 6984A501-8284-49CB-BD97-32B910134DB2
OSTOMY CARE
*In this scenario a 33-year-old female is in the surgical unit, two
days post-operative after removal of the colon and rectum due to a
long history of ulcerative colitis. A colostomy has been created.
The learners are expected to assess and evaluate the colostomy
site, explain the procedures to the patient using an appropriate
communication framework, and provide colostomy care, including
emptying the bag (and reapplying if needed). (Laerdal, Nursing Anne
Scenarios).
Critical Thinking Questions:
• What concerns do you expect the patient to have regarding her
colostomy?
• When is it appropriate to begin to teach the patient how to care
for her colostomy?
• What individuals/specialties need to be on this patient’s
discharge planning team?
• What can she anticipate regarding the progression of her
ulcerative colitis?
PERINEAL CARE & URINARY CATHETERIZATION
As noted, any of the skills can be done in combination with already
developed simulations. This example refers to one of the NLN ACE-V
(Advancing Care Excellence for Veterans) unfolding cases.
http://www.
nln.org/professional-development-programs/teaching-resources/veterans-
ace-v/unfolding-cases/jenny-brown.
*Jenny Brown, 29 years old, was admitted yesterday in labor. She
gave birth approximately 12 hours ago to Samantha, a 7 lb 10 oz
healthy female infant with a right-sided unilateral cleft lip and
palate. The vaginal birth was uncomplicated. A neonatologist, NICU
nurse, and respiratory therapist attended the delivery and provided
immediate newborn care. The boyfriend, Eric, has been here all
night. He just went to get some breakfast and will be back
soon.
In the scenario, Jenny has been up to void several times since
delivery. This report can be changed to state that Jenny has been
up several times since delivery but has been unable to void. You
will need to do perineal care and perform a straight
catheterization for Jenny.
Critical Thinking Questions:
• Why do you suspect this patient is unable to void?
• How will you monitor this patient post catheterization?
DocuSign Envelope ID: 6984A501-8284-49CB-BD97-32B910134DB2
ENEMA OR RECTAL SUPPOSITORY
*Mrs. Sanchez is a 90-year-old resident at a skilled nursing
facility. She is not ambulatory and is being fed a soft diet with
assistance. Mrs. Sanchez has recently developed problems with
constipation. Her last stool was 3 days ago and you are to
administer a fleets enema (or a glycerin suppository.)
Critical Thinking Questions
• What are the possible contributing factors to her
constipation?
• How will you prepare Mrs. Sanchez for this procedure?
• What recommendations can you make to prevent the recurrence of
constipation?
INJECTIONS
The skills trainer can be used to prepare students for a flu
vaccine clinic. They can give repeated intramuscular injections
(using air, not fluid, with the task trainer) until they are
comfortable with the equipment and the procedure.
Critical Thinking Questions:
• What are the risks of the flu vaccine?
• How will you screen patients prior to the vaccine? Are there
people who should not receive it?
• How will you clean your hands and the immediate area after each
dose?
• What teaching will you provide regarding follow up to the
vaccine?
• What is the effectiveness of the flu vaccine? Is this known at
the time of administration?
• What would an allergic reaction to the vaccine look like?
• What will you do if you see signs of an allergic reaction?
DocuSign Envelope ID: 6984A501-8284-49CB-BD97-32B910134DB2
IV CATHETER INSERTION
For faculty and students doing the Laerdal vSim® for Nursing cases,
psychomotor skills can be incorporated with the screen-based
scenario.
*Skyler Hansen is an 18-year-old male diagnosed with type 1
diabetes 6 months ago. He was brought to the Emergency Department
by his friends. The friends report that he started acting “weird”
while they were playing basketball. He has not eaten anything for 5
hours. Skyler told them that he felt lightheaded and was going to
lie down on the cement. They became nervous and decided to bring
him in to the Emergency Department. The patient is drowsy, wakes
with stimulus, has slurred speech, is diaphoretic, and is acting
irrationally. He has not yet been seen by the provider.
After Skyler’s initial assessment, orders are received to obtain IV
access. Students could perform this skill on the skills
trainer.
Critical Thinking Questions:
• A patient has an IV in their right wrist area and needs a new IV.
Discuss your approach to assessing other possible sites for new IV
insertion on the patient’s right extremity.
• How would you respond if Skyler asked you why he needed to have
an IV?
• Discuss what are some complications to the patient when using
intravenous peripheral therapy?
OXYGEN THERAPY
*As the scenario begins, Mr. Williams presents as follows:
• “Bed is flat. Henry is coughing and short of breath. His nasal
cannula has fallen out of his nose
• Vital signs: T 98.2, BP 138/90, P – 112, R - 28;
• Oxygen saturation – 84%
• Henry (wheezing): “I am really short of breath and so
tired.”
Nurses would be expected to do the following:
• Performing hand hygiene
• Confirm patient ID
• Replace cannula in nares (which will be done with the skills
trainer)
Critical Thinking Questions:
• At what liter flow will you start the oxygen
administration?
• What other interventions need to be initiated??
• How is his anxiety impacting his respiratory status?
• If after 1 minute the vital signs are: BP 130/88, P 98, oxygen
saturation 88%, what action should be initiated?
DocuSign Envelope ID: 6984A501-8284-49CB-BD97-32B910134DB2
NASAL SWAB
*Consider that there have been several community cases of a highly
contagious and potentially very serious viral respiratory illness.
The illness has been fatal for people in several high risk groups.
Due to the seriousness of the illness and the potential exposure of
hundreds or possibly thousands of community members, the local
hospital is running several screening centers. The nurses will be
performing nasal swabs to test for the virus.
Critical Thinking Questions:
• What PPE will the nurses need to run this screening center?
• What information should be obtained from the persons being
screened?
• What is the role of the public health department in this
case?
G-TUBE CARE
*Sylvia Vronsky is a 45-year-old woman who suffered a stroke one
month ago. She has been having difficulties with return of speech
and with swallowing. Mrs. Vronsky aspirated during a meal 2 weeks
ago and was hospitalized with pneumonia. Her family decided that a
gastrostomy tube would be helpful, and it was placed yesterday. The
nurses need to demonstrate g-tube care to the family, who will be
taking Mrs. Vronsky home tomorrow morning.
Critical Thinking Questions:
• How often do we need to clean around the tube?
• Do you think her speech and swallowing will come back?
• Will she ever be able to take care of this herself?
• What else will the family need to be taught related to the
g-tube?
• What types of gastrostomy feedings can be done at home?
• What do we do if it comes out?
DocuSign Envelope ID: 6984A501-8284-49CB-BD97-32B910134DB2
Author Mary Cato EdD, RN Assistant Professor Emeritus Oregon Health
& Science University
Contributors Cynthia Sherraden Bradley PhD, RN, CNE, CHSE Assistant
Professor, Director of Simulation University of Minnesota School of
Nursing
Sandra Caballero, MSN, RN, CHSE Texas Tech University Health
Sciences Center
Sharon Decker, PhD, RN, FSSH, ANEF, FAAN Texas Tech University
Health Sciences Center
Heiddy DiGregorio, PhD, APRN, PCNS-BC, CHSE, CNE Assistant
Professor, Director of Simulation University of Delaware College of
Health Sciences
Susan Henley Hébert, MSMS, BSN, CHSE PhD Student in Nursing
Simulation Director University of Tennessee, Knoxville, College of
Nursing
Melissa Leal, EdD©, MSN, RN, CHSE Texas Tech University Health
Sciences Center
Kathryn Whitcomb, DNP, RN, CHSE Texas Tech University Health
Sciences Center
Susan Gross Forneris PhD, RN, CNE, CHSE-A, FAAN Director, NLN
Center for Innovation in Education Excellence
References
NLN Advancing Care Excellence for Veterans.
http://www.nln.org/professional-development-programs/teaching-resources/veterans-ace-v
NLN Advancing Care Excellence for Seniors,
http://www.nln.org/professional-development-programs/teaching-resources/ace-s
Gonzalez, L., & Kardong-Edgren, S. (2017, January). Deliberate
practice for mastery learning in nursing. Clinical Simulation in
Nursing, 13(1), 10-14.
http://dx.doi.org/10.1016/j.ecns.2016.10.005.
Marilyn H. Oermann, PhD, RN, ANEF, FAAN; Virginia C. Muckler, DNP,
CRNA, CHSE; Brett Morgan, DNP, CRNA. 2016.Framework for teaching
Psychomotor and procedural skills in nursing. J Contin Educ Nurs.
2016;47(6):278–282
https://doi.org/10.3928/00220124-20160518-10
© 2021 Laerdal Medical AS. All rights reserved. Rev B.
National League for Nursing
DocuSign Envelope ID: 6984A501-8284-49CB-BD97-32B910134DB2
CLIENT EXECUTIVE Tara Landry (845) 242-0570
[email protected]
To prevent any delays in processing your purchase, please include
your quote # when ordering. DATE: 10/27/2021 QUOTE NUMBER:
Q-499263
CREDIT TERMS: 30 days
ATTN: Ms. Lori Martone-Roberts Associate Professor of
Nursing/Faculty Simulation Liaison +1(401) 258-3420
[email protected] BILL TO: 00110595 COMMUNITY COLLEGE OF Rhode
Island - A/P Dept 400 East Ave Warwick RI 02886
Discounts and free ground shipping per MHEC Contract
MC13-D32.
QTY PRODUCT DESCRIPTION LIST PRICE UNIT PRICE EXTENDED PRICE
185 330-15050 Modular Skills Trainer 2 The Modular Skills Trainer
is a portable solution for skills practice and competency
development. Optimized for distance learning, the Modular Skills
Trainer is an affordable, practical solution for repetitive,
independent skills practice and to assist with skills
validation
$250.00 $212.50 $39,312.50
ITEM TOTAL : $39,312.50 SHIPPING/HANDLING : $0.00 TAX : $0.00
ADDITIONAL CHARGE/CREDIT : $0.00 TOTAL : $39,312.50
There are various payment options; please see bottom of your quote
for further clarification. Appropriate Sales Tax will be added to
invoice – Pricing and Availability are subject to change
Shipping/Handling costs will be added to invoice By Accepting this
Quote, the following terms are hereby incorporated into customer’s
order: Products: Products that are currently on contract will be
removed immediately if manufacturing or distribution of the product
is discontinued.
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DocuSign Envelope ID: 6984A501-8284-49CB-BD97-32B910134DB2
Payment: Net 30 Days for approved open accounts; CIA; Credit Cards
accepted. Financing options now available – sample leasing payment
terms follow. For additional information, ask your Account Manager
listed above. Lease term 24 months: USD 1,638.02 * Lease term 36
months: USD 1,092.01 * Lease term 48 months: USD 819.01 * * Quoted
payments do not include Interest, Taxes, Maintenance, Cancellation
fees or Insurance. Quotes are subject to credit approval and may
change without notice. Warranty: One(1) year warranty on
manufactured products and 90 day warranty on refurbished products
Two(2) year parts replacement warranty with technical assistance by
phone on all Hill-Rom refurbished products Delivery: Delivery of
product to a specific location within your building, if requested
is at an additional charge and not included in this quote Training:
Training will be scheduled within a year of the customer’s agreed
upon due date. CANCELLATION or RESCHEDULING of EDUCATIONAL or
TECHNICAL SERVICES WILL RESULT IN CANCELLATION/RESCHEDULING FEES. 7
DAYS OR LESS: 100% of Course / Service Cost 8 DAYS to 2 WEEKS: 75%
of Course / Service Cost 15 DAYS to 20 DAYS: 50% of Course /
Service Cost 3 WEEKS or MORE: NO FEE Customer will be required to
submit a new PO to reschedule a cancelled course / service.
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DocuSign Envelope ID: 6984A501-8284-49CB-BD97-32B910134DB2