Tier 1 – Small Institutions: Primary/secondary school, private practice office or private clinic that does no teaching or research, residency program, general reference public library, museum, or non-profit administrative office.

Tier 2 – Small Offices, Colleges, General Research/Reference or Charitable Institution: Community, technical, or associates level higher education colleges; institutes of technology, undergraduate or Masters level college/university, nursing school or allied health training program, seminaries, community hospital or clinic (no research), health policy or advocacy non-profit office/charitable organization, independent research library, small non-profit or government laboratory; professional society or trade union/industry trade association, local or regional government agency/ministry.

Tier 3 – Core Research Organizations/Institutes: Doctorate-granting research university, medical or pharmacy school, teaching or research hospital or clinic, private, non-profit research institute, small for-profit independent company, partnership, or organization.  Must be single campus/site.

Tier 4 – Large, Regional, Networked Single Organizations: Multi-site single academic institution, private non-profit research organization or Healthcare network, large regional non-profit/government research institute or government agency, mid-size for-profit organization.

Tier 5 – Very Large Institutions or Groups of Institutions. Major high usage institutions.