New Post Survey Questionaire (nPSQ)

The New PSQ has less steps and is easier and faster to complete.

  • Please complete this form as you can as soon as you can while your experience is still fresh.  Survey feedback specific to psychiatric hospitals is especially rare and valuable.
     
  • •Don't forget to download surveyor photos and bios during your survey since it is the only time they are available. Please be professional in your profiling comments about them.

 

or click here to download a copy of this form to submit by e-mail. 

 

***** e-Form Instructions & Cautions *****

  •  DO NOT HIT the ENTER key!  It will cause your form to reset and your entries will be erased.  Instead use the TAB key to proceed to the next field.
  • Plan to complete the form in one session.  If you leave the page, your data will not be retained [Hint - you may want to first print out a hard copy of the form. Then complete a handwritten draft to organize your thoughts and serve as your guide for entering online]
  • You must check the box indicating acceptance of the Privacy Policy or your form will not be submitted.
  •  When your form is successfully submitted, you will receive an automated e-mail confirmation. 

 

Step 1

* Required fields
Name *
E-mail Address *
Your Position/Title *
Your Phone #:
Facility Name/State *
Surveying Agency *
Surveyor (MD) - Name/Disc: (e.g., John J. Jones, MD/Psychiatrist)
___Standards cited by this surveyor:
___Compliments from this surveyor (programs, practices, policies, forms, etc):
___Tips for working effectively with this surveyor/Special likes/dislikes:
Surveyor (RN) - Name/Disc:
___Standards cited by this surveyor:
___Compliments from this surveyor (programs, practices, policies, forms, etc):
___Tips for working effectively with this surveyor/Special likes/dislikes:
Surveyor (LSCS) - Name/Disc:
___Standards cited by this surveyor:
___Compliments from this surveyor (programs, practices, policies, forms, etc):
___Tips for working effectively with this surveyor/Special likes/dislikes:
Surveyor (Other1) - Name/Disc:
___Standards cited by this surveyor:
___Compliments from this surveyor (programs, practices, policies, forms, etc):
___Tips for working effectively with this surveyor/Special likes/dislikes:
Surveyor (Other2) - Name/Disc:
___Standards cited by this surveyor:
___Compliments from this surveyor (programs, practices, policies, forms, etc):
___Tips for working effectively with this surveyor/Special likes/dislikes:
If you said 'No' to either of the last 2 questions, please tell us why.
**Misc Comments, Suggestions, Etc

I have read and agree to the Privacy Policy *

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