Verification Program Evaluation

* 1. Were the questions on the PRQ clear?

Yes

* 2. What sections of the PRQ need greater clarity?

* 3. Were there issues with entering data?

Yes

If yes, what were the challenges?

* 4. Was the Central Office responsive in scheduling your verification visit?

Yes

If no, please explain.

* 5. Did the Central Office answer your questions or concerns in a timely manner?

Yes

If no, please explain.

* 6. Did the site surveyors clearly communicate the ABA/ACS Verification process?

Yes

If no, please explain.

* 7. Did the site surveyors conduct the visit in a professional manner?

Yes

If no, please explain.

* 8. Did the site surveyors provide constructive insights into your program?

Yes

* 9. Was the review process of your burn center fair and objective?

Yes

* 10. Were there any specific concerns with any part of your visit?

Yes

If yes, please explain

* 11. How can we improve the ABA/ACS Verification process?

* 12. Please provide burn center information.

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

* 1. Were the questions on the PRQ clear?

* 2. What sections of the PRQ need greater clarity?

* 3. Were there issues with entering data?

* 4. Was the Central Office responsive in scheduling your verification visit?

* 5. Did the Central Office answer your questions or concerns in a timely manner?

* 6. Did the site surveyors clearly communicate the ABA/ACS Verification process?

* 7. Did the site surveyors conduct the visit in a professional manner?

* 8. Did the site surveyors provide constructive insights into your program?

* 9. Was the review process of your burn center fair and objective?

* 10. Were there any specific concerns with any part of your visit?

* 11. How can we improve the ABA/ACS Verification process?

* 12. Please provide burn center information.

* 13. Please provide date of site visit.