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Peer Reviewer
*
1.
Reviewer name
(Required.)
*
2.
Reviewed facility name
(Required.)
3.
Type of review
Off-Site Focus
On-Site Focus
Routine/Recredentialing
*
4.
Did you receive sufficient guidance/materials/documents?
(Required.)
Yes
No
Explain: could this be improved?
5.
Was the coordination of this review timely?
Yes
No
If no, explain
6.
How satisfied are you with your compensation?
Extremely satisfied
Very satisfied
Somewhat satisfied
Not so satisfied
Not at all satisfied
7.
If this was an onsite review, was the facility staff...
professional?
communicative?
responsive?
N/A
8.
Suggestions for improvement?