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Peer Reviewee
*
1.
Organization and Name of Person Reviewed
(Required.)
2.
Type of Review
Routine/recredentialing review
Focused review
Onsite review
N/A
*
3.
Did you have an opportunity to meet with the reviewer(s)?
(Required.)
Yes
No
N/A
Was this helpful? Explain:
4.
Were the reviewers?
Yes
No
Organized
Yes
No
Responsive to your needs
Yes
No
Professional
Yes
No
Polite
Yes
No
Objective
Yes
No
Able to provide feedback
Yes
No
Please explain:
5.
Did the report provide useful recommendations?
Yes
No
Please explain:
*
6.
Overall, did you feel the process was constructive??
(Required.)
Yes
No
Explain:
7.
Suggestions for improvement?