AHQA Feedback Tool

Please fill in the form below to submit your feedback.

 

Measurement Feedback Tool

  • Is this feedback on behalf of another person or organization?
  • What is the organization name?
  • Submitting Organization's name:
  • What is this type of practice?
  • If you selected "other" please describe below:
  • Please select all that apply to this practice:
  • Specialty
  • If you selected "other" please describe it below:
  • What is the size of the practice? (i.e. number of Practitioners)
  • In which state is the practice located?
  • Is this practice rural or urban?
  • NQF Measure Name & Number
  • If the measure is not on the list above, please write it below:
  • How frequently is this measure used?
  • If you selected "other" please describe below:
  • The feedback your providing is related to what particular primary use?
  • If you selected "other" please describe below:
  • What challenges (if any) are you having with implementation?
  • If you selected "other" please describe below:
  • What improvements would you suggest for this measure?
  • What best practices do you have to share for this measure?
  • Please provide any additional feedback you haven't already shared: