Download:
pdf |
pdfYour home health care agency may want to review your answers so that they can decide how to
address any concerns that you have. We will not share your answers to this survey linked to your
name unless you give your permission for this information to be shared with your home health
agency.
Q35. Do you give your permission to provide your answers to this survey linked to your name to
your home health agency?
1
2
Yes, I give my permission to share my name and survey responses with my home
health care agency.
No, I do not give permission to share my name and survey responses with my home
health care agency.
| File Type | application/pdf |
| File Title | Consent_share identifying HHCAHPS data |
| Subject | permission to share identifiable data, Private health information, HHCAHPS PHI, HHCAHPS PII |
| Author | CMS_HHCAHPS Coordination Team |
| File Modified | 2013-01-07 |
| File Created | 2010-03-17 |