American Psychological Association Division 40 (Clinical Neuropsychology) Records

(Mss. 4745)

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ADDENDUM F

JCAH
Joint Commission on Accreditation of Hospitals

Evaluation Form
Proposed Revisions to the Accreditation Manual for Hospitals

INFORMATION AND INSTRUCTIONS

Name________________________________________________________________________________________________________________

Address______________________________________________________________________________________________________________

Professional Discipline__________________________________________________________________________________________________

Are You Responding as an Individual?    Yes_____    No_____

Do You Officially Represent An Organization/Agency?  Yes_____  No_______

If Yes, Name of Organization_____________________________

NB:  If you provide psychiatric/substance abuse service(s), please provide the information requested on the reverse side of this form.

INSTRUCTIONS

We would appreciate your reviewing and evaluating each standard revision, interpretation, and/or characteristic to determine whether it is acceptable (Yes) or not acceptable (No). If you indicate that a standard, interpretation, or characteristic is not acceptable (No), please provide reasons in the space allotted under "Comments."

Please return the entire document, intact, with your completed evaluation no later than February 4, 1983, to:

Department of Standards
Joint Commission on Accreditation of Hospitals
875 N. Michigan Avenue
Chicago, Illinois  60611

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Types of Service Number of Beds Number of Outpatient Vists Per Year
Adult Psychiatric General Hospital
Free Standing
Child/Adolescent Psychiatric General Hospital
Free Standing
Alcoholism General Hospital
Free Standing
Drug Abuse General Hospital
Free Standing
Community Mental Health General Hospital
Free Standing
Residential Free Standing

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