UNIVERSITY OF PITTSBURGH FORM INSTRUCTION GUIDE 

FORM NUMBER:      FORM 0001 PITT 1173

FORM TITLE:            Policy/Procedure Approval

PROCEDURE:           01-01-01 and 01-01-02

EFFECTIVE DATE:    September 6, 1989

PAGE (S):                   1

ENTER THE FOLLOWING INFORMATION WHERE INDICATED:

1.    Policy/Procedure Document Number

2.    Page Number(s) of Policy/Procedure Approval Form(s)

3.    Date

4.    Specify Policy Document or Procedure Document

5.    Category Title

6.    Section Title

7.    Subject Title

8.    Author of the material

9.    Coauthor, if applicable

10.   Required Approval Signatures with dates