What Temporary Healthcare Staffing Agencies Do You Contract With? Survey

Kansas HealthCare Association and LeadingAge Kansas continue to work together to advocate to rein in unfair business practices by some temporary healthcare staffing agencies. We need information that only you can provide. Thank you for taking a few minutes to answer these important questions.

1.Do you have contracts with temporary healthcare staffing agencies (check one):

We have no temporary healthcare staffing agency contracts at this time

We contract with temporary healthcare staffing agencies

2.If you contract with one or more temporary healthcare staffing agencies, please provide the following information for all contracted agencies:

Agency Name

Address

City/Town

State/Province

ZIP/Postal Code

Your Primary Contact with the Agency

Email Address

Phone Number

3.Additional temporary healthcare staffing agencies information (if you have no others please skip):

Agency Name

Address

City/Town

State/Province

ZIP/Postal Code

Your Primary Contact with the Agency

Email Address

Phone Number

4.Additional temporary healthcare staffing agencies information (if you have no others please skip):

Agency Name

Address

City/Town

State/Province

ZIP/Postal Code

Your Primary Contact with the Agency

Email Address

Phone Number

5.Additional temporary healthcare staffing agencies information (if you have no others please skip):

Agency Name

Address

City/Town

State/Province

ZIP/Postal Code

Your Primary Contact with the Agency

Email Address

Phone Number

6.Additional temporary healthcare staffing agencies information (if you have no others please skip):

Agency Name

Address

City/Town

State/Province

ZIP/Postal Code

Your Primary Contact with the Agency

Email Address

Phone Number

7.Additional temporary healthcare staffing agencies information (if you have no others please skip):

Agency Name

Address

City/Town

State/Province

ZIP/Postal Code

Your Primary Contact with the Agency

Email Address

Phone Number

8.Additional temporary healthcare staffing agencies information (if you have no others please skip):

Agency Name

Address

City/Town

State/Province

ZIP/Postal Code

Your Primary Contact with the Agency

Email Address

Phone Number

9.Additional temporary healthcare staffing agencies information (if you have no others please skip):

Agency Name

Address

City/Town

State/Province

ZIP/Postal Code

Your Primary Contact with the Agency

Email Address

Phone Number

10.Additional temporary healthcare staffing agencies information (if you have no others please skip):

Agency Name

Address

City/Town

State/Province

ZIP/Postal Code

Your Primary Contact with the Agency

Email Address

Phone Number

If you have anymore temporary healthcare staffing agencies you use, please include that information at the end of the survey.

11.Are there temporary staffing agencies that you will not contract with due to critical quality, reliability issues or very poor reputation?

Yes

If you answered yes, please include the agency name and reasons you choose not to contract with this agency.

12.Please include your demographic information:

Name

Organization

City

Email Address

13.If you have any other information to provide regarding temporary healthcare staffing agencies please include it here.

Thank you for your time and information.