Introduction, Contact Information

To help DDD fully understand issues facing our provider network, please take the time to answer the questions below. This survey is specific to nursing providers. Please be as accurate and detailed as possible to inform DDD decision making. The goal of this survey is to better understand each vendor’s current situation and is not meant to be punitive.

Please only provide information as it pertains to the services outlined in this survey for DDD. If your agency provides additional services do your best to estimate the portion of information that applies to these services for DDD members.

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* 2. Please enter your AHCCCS ID

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* 3. Please enter your employer ID

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* 4. Please enter the following contact information

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* 5. Does your agency provide nursing services? (HN1, HNR, HN9, HNV)

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