Name * Organization * Organization Type * ASC Regional Leader Other Phone number Email * ASC Survey Section * Please select the ASC Survey section for which you are providing a comment. To provide comments for additional sections, you will need to submit a comment form for each section.- Select -Section 1: Basic Facility InformationSection 2: Medical, Surgical, and Clinical StaffSection 3: Volume and Safety of ProceduresSection 4: Patient Safety PracticesSection 5: Patient Experience ASC Survey Subsection * Please select the ASC Survey measure for which you are providing a comment. To provide comments for additional measures, you will need to submit a comment form for each measure.- Select -Section 1A: Basic Facility InformationSection 1B: Billing EthicsSection 1C: Health Care EquitySection 2: Medical, Surgical, and Clinical StaffSection 3A: Volume of ProceduresSection 3B: Facility and Surgeon VolumeSection 3C: CMS Outcome MeasuresSection 3D: Informed ConsentSection 3E: Safe Surgery Checklist for Adult and Pediatric Outpatient ProceduresSection 4A: Medication SafetySection 4B: NHSN Outpatient Procedure Component ModuleSection 4C: Hand HygieneSection 4D: National Quality Forum (NQF) Safe PracticesSection 4E: Never EventsSection 4F: Nursing WorkforceSection 5: Patient Experience (OAS CAHPS) Comments * Please provide a comment for the section selected from the drop-down menu above. To provide comments for additional sections, you will need to submit a comment form for each section. Submit
