| Meeting Title: | Meeting Needs: | |
| Date: Location: | Flip Chart/Marking Pens | |
| Meeting called by: Phone: | Overhead Projector | |
| Goals (Broad): | VHS Player/Monitor | |
| Refreshments | ||
| Objectives (Specific): | ||
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| Start: | Facilitator(s): |
| Stop: | Timekeeper(s): |
| Recorder(s): | |
| Scribe(s): | |
| Observer(s): |
| Name | Preparation Tasks | Expertise |
| Person Responsible | Topic/Activity | Desired Outcome | Time Allotted |
| Review/Revise Agenda | |||
| Establish/Review Ground Rules | |||
| Parking Lot | |||
| Summary, Next Steps, Action Items | |||
| Quality Review - Observer Feedback |