Survey for Nursing Homes to Indicate Interest in a 90-minute Virtual Feedback Session

Please complete the survey below to indicate your facility's interest.

Your facility is being invited to Participate in a Feedback Session exploring a new approach to reduce the burden of reporting Healthcare-Associated Infections (HAIs) to the Centers for Disease Control and Prevention’s (CDC), National Healthcare Safety Network (NHSN).

Note that all answers provided will be kept confidential, will only be accessible by the Arbor Research team, and will only be used for the purposes of scheduling the feedback session.

If you have any questions regarding the survey or the session, please contact Michelle Maxim, Project Manager, at Michelle.Maxim@ArborResearch.org.

Thank you!

Question Title

* 1. Please provide the name of your facility:

Question Title

* 2. Please list the name, phone number, and email of the person completing the survey:

Name

Email Address

Phone Number

Question Title

* 3. Is your facility interested in joining the feedback session?

Yes

Other (please specify)