BHC Free Accreditation Manual Trial 2012
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1. Registration Information

Thank you for your interest in Joint Commission accreditation. You are registering to receive free 60-day trial access to The Joint Commission's "E-dition", an enhanced on-line version of the Comprehensive Accreditation Manual for Behavioral Health Care.

Please complete this registration. All questions with an * are required.

Instructions for activating your free 60-day trial will be emailed to you after your registration has been received. For questions related to this form, please e-mail mlehman@jointcommission.org

We value your privacy. Please note that we do not share this information with outside sources.

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1. First Name

First Name

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2. Last Name

Last Name

3. Title

Title

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4. Organization Name

Organization Name

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5. Street Address

Street Address

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6. City

City

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7. State

State

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8. Zip Code

Zip Code

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9. Telephone Number

Telephone Number

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10. Email address:

Email address:

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11. Would you like us to contact you to provide assistance?

Would you like us to contact you to provide assistance? Yes, please contact me

No. Please do not contact me.

Other (please comment):

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12. Which of the following best describes your organization's status? (check all that apply)

Which of the following best describes your organization's status? (check all that apply) Accredited by The Joint Commission for Behavioral Health Care

Accredited by The Joint Commission for Hospital or other program

Accredited by another accrediting body

Not currently accredited

Not a candidate for accreditation

BHC Free Accreditation Manual Trial 2012Exit this survey >>

1. Registration Information

*1. First Name

*2. Last Name

3. Title

*4. Organization Name

*5. Street Address

*6. City

*7. State

*8. Zip Code

*9. Telephone Number

*10. Email address:

*11. Would you like us to contact you to provide assistance?

*12. Which of the following best describes your organization's status? (check all that apply)