DPH OHCA Outpatient Surgery Questionnaire |
1. Introduction
| 10% |
Please complete the following survey to identify the location and utilization volumes for outpatient surgery in Connecticut for Calendar Year 2010.
The information you provide on this questionnaire should describe outpatient surgery that is performed at one physical location. If another outpatient surgery site, campus or satellite is owned and/or operated by the same provider, please complete a separate questionnaire for the additional location (e.g., West Hartford Surgery Center in West Hartford should be completed on a separate questionnaire from Hartford Hospital main campus).
To navigate the pages that follow, use your mouse to click in the first reply box on a page and then use the tab key or mouse to toggle through the remaining questions. Yes/No questions can be selected using your mouse or by tabbing to the appropriate response and pressing the space bar.
This questionnaire should require approximately 15 minutes to complete for each location.
To continue, click on "Next" below, otherwise click on "Exit this survey" in the upper right hand corner of this page.
The information you provide on this questionnaire should describe outpatient surgery that is performed at one physical location. If another outpatient surgery site, campus or satellite is owned and/or operated by the same provider, please complete a separate questionnaire for the additional location (e.g., West Hartford Surgery Center in West Hartford should be completed on a separate questionnaire from Hartford Hospital main campus).
To navigate the pages that follow, use your mouse to click in the first reply box on a page and then use the tab key or mouse to toggle through the remaining questions. Yes/No questions can be selected using your mouse or by tabbing to the appropriate response and pressing the space bar.
This questionnaire should require approximately 15 minutes to complete for each location.
To continue, click on "Next" below, otherwise click on "Exit this survey" in the upper right hand corner of this page.