NAVREF Peer Review Request Form

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1. Please select your organization (listed alphabetically by state): (Required.)

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2. Name:

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3. Role:

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4. Email:

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5. Select your preferred date for the visit from the peer reviewers. Please note we try to schedule BPCs at least 3 months in advance. We will do our best to accommodate your preferred date.

Date / Time

Date

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6. Which of the following areas would you like the reviewers to focus on?

Governance

Finance

Operations

HR

Clinical Trials

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7. Tell us a little bit about why you are requesting a peer review and what your organization hopes to gain from NAVREF's visit.