Intent to Translate Form

This form must be completed by any person(s) wishing to undertake translation of the DASH and QuickDASH Outcome Measures.

Note: if you intend to perform more than one DASH translation, you must complete and submit an individual intent to translate form for each language translation.

1. I intend to undertake a translation of the DASH and QuickDASH Outcome Measures together with related scoring instructions for each instrument.

2. I agree to follow closely the instructions provided in the Recommendations for the Cross-Cultural Adaptation of Health Status Measures and have read, understood and agree to follow the information provided in the Translation Guidelines.

3. I agree to provide brief status reports of my progress with the translation at four-month intervals from the initial date of approval of this intent.

4. I agree that if I do not inform the Institute of my progress as stated above (#3), over the course of one year from the date of approval of this intent (which is also identified as your project start date), that the Institute may give permission to other interested parties, on request, to do the translation and that this intent to translate the DASH will be canceled.

5. If the translation is still in progress at the end of one year, I will inform the Institute of my intention to complete it and also provide an estimated date for its submission. This intent to translate the DASH will remain in effect for an extended period agreed on between the Institute and the translator.

If you are in agreement with the above conditions, please make a check mark against the box below: