This outcome measurement and evaluation toolkit and related resources are based on the Flex Monitoring Team's (FMT's) extensive experience with monitoring and evaluating State Flex Program (SFP) performance and in working with SFPs to improve their ability to identify and monitor outcome measures. The FMT developed this toolkit and webinar to assist SFPs with managing and documenting project performance and complying with the Federal Office of Rural Health Policy’s (FORHP’s) expectations regarding outcome measurement and reporting. This toolkit is organized into six sections that provide a process to assist SFPs in monitoring their projects and demonstrating project impact. Each section provides one or more sample worksheets to illustrate the material covered. Section 7 provides blank worksheets for SFPs as they work through the steps for their projects. The recorded webinar covers the toolkit and worksheets as well as the use of the worksheets for a cohort-based project to improve hospital performance on the emergency transfer communication (EDTC) measures.