Related links | About PARS | Intervention | VUMC Policy | Data Form for Collaboration

The information requested below will help us determine your readiness to implement PARS. We pledge that this information will remain confidential.
Name of Medical Facility or Group
 Required
Address 1
      
Address 2
      
City
      
State
      
Zip
      
Website
      
Contact: First Name
 Required
Last Name
 Required
Phone
 Required
E-mail
      
How many physicians have privileges with this medical facility and/or group?
How many physicians with privileges have patient contact (excl. pathologists, non-interventional radiologists and anesthesiologists)?
How many beds are at this medical facility and/or group?
How many unsolicited patient/family complaints are received each year?
What system is utilized for complaint capture (name of software and version)?  
   
Is the data available in electronic form?
How many years of complaint data are available?
Additional Comments:  
   
   

 

 

 

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