Life Care Media Center

Upon completion of steps 1 and 2 below, please print and return to Vangie Ruth, Corporate Media Production.
We cannot proceed without the proper approvals listed in step 3.

Step #1

Proposed Project Name:*

Date Needed:

Type of Video:*

Proposed Length:

Step #2

Has Life Care previously produced a video on this same subject?*

Yes No

If yes, what is the title?

Does the content of the project overlap a current video project or training course?*

Yes No

If yes, what is the title?

List any collateral materials currently available on the subject (if any):

How long with this content be relevant?

How often is this likely to require updates?

Who is the audience? (ex. CNAs, DONs, EDs, corporate associates, residents, families, the community, etc.)

What is the audience's current knowledge and attitude about the topic?

With regards to viewing, this video will be:
Voluntary
Mandatory
Viewed with a presenter

What main point or points do you wish to make in the program? Describe any elements that will be helpful in demonstrating any of the points that you wish to communicate. (ex. photographs, charts, videotapes, etc.)

Who will be the content expert(s)?*

Who has final approval at all stages of this project, script, DVD menu, and the completed video?*

Will a Spanish translation be needed?*

Yes No

How many copies with be required?

Step #3

It is the responsibility of the requester to acquire all signatures before submitting this form to CMP.

Signature of requester: ________________________________________	Date: _______________
Requester's Dept. VP: ________________________________________	Date: _______________
Beecher Hunter: ________________________________________	Date: _______________

The production timeline (including scripting) will begin after all approvals have been received.
No production will begin until a completed script has been approved by the script approver named in the form.

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Step #3