Site Launch Closeout

Account Launch Closeout Form

v12.20.2025
Client Name*
License Number (Make sure this is Accurate)*
Date(s) of Launch*
Location(s) of Launch*
Launch Personnel and Inclusion/Exclusion Criteria
Name of Primary Launch Rep*
Email of Primary Launch Rep*
Names/Emails of Launch Supporting Personnel (IE Other Reps, Safe Balance Staff, etc)
Describe the Current INCLUSION Criteria (IE 60+, Every 30-90 Days, etc)*
Describe the Current EXCLUSION Crieteria if any (IE Surgical Status, Non-Par Insurances, etc)*

Hardware/Software Setup

For the tech setup, you want to make SURE that the tablets are connected to the PRIVATE WiFi of the clinic (NOT the Guest Network), that Chrome (preferred) or Edge (secondary) is the website browser of use. Make sure the bookmarks bar is accessible for quick reference to all users.
Notes on Hardware Setup (is client using their own tablets? Are computers in exam rooms or at workstations? etc)*

Clinical Staff/Front Desk Training
Complete each of these steps with each staff member trained*
The following training steps are to be completed with designated personnel depending on the workflow design of the practice (IE is screening completed by front desk or MA staff. If front desk is completing questionnaire, then no need to train MA staff on that step, etc)
Starting the Screening Questionnaire:*
Completing the Physical Performance Testing and Documenting:*
Names of Staff Trained*
Additional notes on staff/provider training (staff resistance, short handed, etc)*

Closeout and Review
Front Desk Acceptance of Program:
MA Staff Acceptance of Program
Provider Acceptance of Program
Admin/Manager Acceptance of Program
Overall Client/Site Acceptance of Program
Any other important notes/information (resistant personnel/names, workflow concerns, billing questions, etc)*
Should be Empty:

Account Launch Closeout Form