Verification Program Evaluation Question Title * 1. Were the questions on the PRQ clear? Yes No OK Question Title * 2. What sections of the PRQ need greater clarity? OK Question Title * 3. Were there issues with entering data? Yes No If yes, what were the challenges? OK Question Title * 4. Was the Central Office responsive in scheduling your verification visit? Yes No If no, please explain. OK Question Title * 5. Did the Central Office answer your questions or concerns in a timely manner? Yes No If no, please explain. OK Question Title * 6. Did the site reviewers clearly communicate the ABA/ACS Verification process? Yes No If no, please explain. OK Question Title * 7. Did the site reviewers conduct the visit in a professional manner? Yes No If no, please explain. OK Question Title * 8. Did the site reviewers provide constructive insights into your program? Yes No OK Question Title * 9. Was the review process of your burn center fair and objective? Yes No OK Question Title * 10. Were there any specific concerns with any part of your visit? Yes No If yes, please explain OK Question Title * 11. How can we improve the ABA/ACS Verification process? OK Question Title * 12. Please provide burn center information. Name Company Address Address 2 City/Town State/Province -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP/Postal Code Country Email Address Phone Number OK Question Title * 13. Please provide date of site visit. OK DONE