LTC Value of Accreditation Download
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Thank you for your interest in The Joint Commission's Long Term Care accreditation program. Please complete this brief form to help us better serve you. The file will follow.
For questions related to this form, e-mail
navello@jointcommission.org
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First Name
First Name
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Last Name
Last Name
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Title
Title
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Organization Name
Organization Name
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Street Address
Street Address
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City
City
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State
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
State
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Zip Code
Zip Code
Telephone Number
Telephone Number
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E-mail Address
E-mail Address
How would you describe your organization? (Please check all that apply)
How would you describe your organization? (Please check all that apply)
Skilled Nursing Facility
Veteran's Administration Facility
Other (please specify)
Are you currently accredited as a stand-alone Joint Commission Long Term Care organization?
Are you currently accredited as a stand-alone Joint Commission Long Term Care organization?
Yes
No
Don't Know
When would you be interested in becoming Joint Commission Long Term Care accredited?
When would you be interested in becoming Joint Commission Long Term Care accredited?
Already Joint Commission accredited
Within 6 months
6-12 months
12-18 months
Not sure about timing
Not interested
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