Global Accreditation Application Overview

CEO Cancer Gold Standard™

Global Accreditation Application Overview

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Requirements:

Employers who wish to apply for global Gold Standard accreditation must:

1. Achieveand maintain CEO Cancer Gold Standard™accreditation in the U.S.

1. Maintain a tobacco-free policy worldwide, in all business locations where permissible by law and/or where there are no other exceptional circumstances (e.g. security concerns) where being tobacco-free would jeopardize the security of your employees. Your tobacco-free workplace policy must be submitted to the Accreditation Review Board for review.

1. Complete the Essay Question portion of this application, limiting your response to each question to approximately 300 words or fewer. They will be reviewed by the Accreditation Review Board members. Please note that for the essay questions (organized by Pillar),you do not need to provide a location-by-location detailed description. Rather, it is important to provide an overview of your activities outside of the U.S. in each respective Pillar such that the reviewers will gain a sufficient sense that your employees outside the United States are an integral part of your culture of health and wellness, and that your organization is meeting the essence of the CEO Cancer Gold Standard™.

Application Instructions:

1. Complete and submit the Essay Questions (Part A)
2. Complete and submit the Global Gold Standard Preparer Certification Form (Part B)
3. Submit your Worldwide Tobacco-Free Workplace Policy

All information must be submitted to:

CEO Roundtable on Cancer

100 SAS Campus Drive

Cary, NC 27513

919/531.0962

Essay Questions for Global Accreditation (Part A)

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Pillar #1:Prevention

Describe the tobacco-cessation treatment programs your non-US employees and family members may receive.

Please comment on the types of treatment they may receive in order to quit the use of tobacco. Tobacco-cessation treatments, including counseling and medications, may be provided by you as the employer and/or by another entity such as a national health service.

Describe any programming you have in place to encourage employees to quit and remain tobacco free.

What kinds of things are you doing in your various non-US locations to encourage quitting the use of cigarettes and all forms of tobacco, including e-cigarettes and all other forms of electronic nicotine delivery systems (ENDS). Please include 2-3 examples.

Provide examples of what you are doing in non-US locations to support and encourage your employees to make healthy food choices, be physically active, maintain a healthy weight, and be vaccinated to prevent cervical cancer.

Please include information about how you educate your employees about good nutrition, the health benefits of maintaining a healthy body weight and the health benefits of being physically active, and the importance receiving appropriate vaccinations.

Pillar #2: Screening

Describe what you are doing to promote and encourage age and gender-appropriate cancer screenings (for breast, cervical and colorectal cancers), applicable to your local employee health concerns and to your regional health system.

Please include 2-3 specific examples.

Pillar #3: Cancer Clinical Trials

Describe how your employees are being educated about the value of considering participation in a cancer clinical trial.

Include 2-3 examples of the types of education you are doing to raise awareness about the importance of cancer clinical trials. Please focus on regions of the world in which you are operating where employees have access to clinical trials.

Pillar #4: Quality Treatment and Survivorship

Provide information about where your employees may be treated for cancer.

Recognizing that this will vary by location, please include a statement specifying that, to the extent possible, you strive to provide your employees access to quality care within the context of a given country’s specific health care system. Please include information on any alliances you may have formed with local health services, medical associations, NGOs and/or advocacy groups to in order to promote access to quality cancer care. Indicate any resources and educational materials you provide in order to meet the needs of employees who are cancer survivors or who may be caring for a cancer survivor.

Pillar #5: Health Education and Health Promotion

Provide information about how you educateemployees about what they can do to prevent cancer, when and why they should be screened for certain cancers, the value of cancer clinical trials, and why quality cancer treatment makes a difference.

Please include a few examples of your communication and education efforts.

Certification Form to be signed by Preparer and CEO (Part B)

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Your organization’s name:

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Number of worldwide employees:

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Headquarters mailing address: ______

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I hereby certify that all information contained in this application for accreditation as a globalCEO Cancer Gold Standard employer is accurate.

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Preparer’s NameDate

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TitleEmail Addressand Phone Number

Preparers Mailing Address:

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CEO NameTitle

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CEO SignatureDate

All decisions regarding CEO Cancer Gold Standard™ accreditation are at the sole discretion of the CEO Roundtable on Cancer.

Revised July 2014