Reader worksheet

The Full Fifteen Pillars Assessment

The full-size printable worksheet from the back of Before You Trust It.

Forty-five questions, three for each pillar, with room to record your answer, the evidence, the owner, and your next action. Print it, or fill it in right on your screen.

Download the worksheet PDF · US Letter · 18 pages · Free for readers
Front page of the Fifteen Pillars Assessment worksheet, with more pages fanned out behind it

How to use it

A working plan, not just a score.

  1. 1

    Answer against the SOP Standard

    Answer Yes only if it is in writing, owned by an accountable person, and reviewed on a schedule. Use Partial when something exists but doesn’t yet meet that standard. Use No when it doesn’t exist.

  2. 2

    Write down the evidence

    For every answer, note where the evidence lives and who owns it. For every Partial or No, write the corrective action and the date you’ll review it again.

  3. 3

    Compare with the floor

    Take it once on your own. Then hand it to your front desk coordinator and a clinical assistant, and compare. Where their answers differ from yours, trust the floor, and find out why.

Critical first

Four pillars are marked critical: Authorization, Human Authority, Escalation, and Data Handling. A gap in any of them on a tool that’s touching patients needs attention first, no matter how the rest of your answers look.

This is a practice-based self-assessment, not a certification. It has not been formally validated, and a high score doesn’t mean a tool is safe to deploy or that your practice is compliant. For legal and regulatory conclusions, work with qualified professionals.

Reader bonus

The Fifteen Pillars Prompt Pack

One prompt for every pillar, so you can take the book off the shelf and put it to work in your practice.

Get the prompt pack