Ethics Consultation Case: Team Leader Form Date(Required) MM slash DD slash YYYY Title of Ethics Case Assigned Case Number(Required) Urgency of consultation(Required)Highly urgent -- 1 to 2 daysWithin 1 weekWithin a monthWithin 2 monthsTeam Leader(Required) First Last Date of Team Leader's Initial Reply to Requestor MM slash DD slash YYYY Text of Team Leader's Initial Reply to RequestorDate Potential Team Members Informed (consult request forwarded) MM slash DD slash YYYY Team Members Available & Selected Constance Holden Jean Abbott Peg Battin Lynette Cederquist Jeanne Kerwin Charles Miller Deborah North Thaddeus Pope Katalin Roth Yvette Vieira Lonny Shavelson Phase 1: Information Gathering, assigned and out to, date of requested return. Phase 2: Additional Information obtained from. Requestor, family member, specialists, etc. Phase 3: Meetings (Date, in attendance, site or Zoom, issues discussed)Phase 4: Assessment/Discussions/ThemesPhase 5: RecommendationsPhase 6: Follow up. Resolutions. Outcome.Upload a File if NeededMax. file size: 50 MB.