CAHPS® Clinician & Group Survey

Notes

Version: 3.0
Population: Adult
Language: English

References to “this provider” rather than “this doctor:” This survey uses “this provider” to refer to the individual specifically named in Question 1. A “provider” could be a doctor, nurse practitioner, physician assistant, or other individuals who provide clinical care. Survey users may change “provider” to “doctor” throughout the questionnaire. For guidance, please see Preparing a Questionnaire Using the CAHPS Clinician & Group Survey.
Supplemental items: Survey users may add questions to this survey. Please visit the CAHPS Web site to review supplemental items developed by the CAHPS Consortium and descriptions of major item sets.

For assistance with this survey, please contact the CAHPS Help Line at 800-492-9261 or cahps1@westat.com.

Instructions for Page 1

Replace the first page of this survey with your own. Include a user-friendly title and your own logo.

Include this text regarding the confidentiality of survey responses:

Your Privacy is Protected. All information that would let someone identify you or your family will be kept private. {VENDOR NAME} will not share your personal information with anyone without your OK. Your responses to this survey are also completely confidential. You may notice a number on the cover of the survey. This number is used only to let us know if you returned your survey so we don’t have to send you reminders.
Your Participation is Voluntary. You may choose to answer this survey or not. If you choose not to, this will not affect the health care you get.
What To Do When You’re Done. Once you complete the survey, XXX.

If you want to know more about this study, please call XXX-XXX-XXXX.