Get Agreement To Participate

Filling out the Agreement To Participate is an important step for facilities wanting to utilize the National Healthcare Safety Network (NHSN). This guide provides clear and user-friendly instructions to help you navigate the online form efficiently.

Follow the steps to fill out the Agreement To Participate

1. Click the ‘Get Form’ button to obtain the Agreement To Participate and open it in your preferred digital editor.
2. Begin by entering the name of your facility in the designated field to identify the organization applying for participation.
3. Provide the contact information of a senior executive at your facility who will review and sign the agreement. Ensure their name, title, and email address are correctly filled in.
4. Carefully read the data access and confidentiality provisions outlined in the agreement. This section outlines who will have access to your data and the purposes for which it will be used.
5. Discuss and confirm with the senior executive whether to grant access to state health departments and the Centers for Medicare and Medicaid Services (CMS) as required by the updated agreement.
6. Complete any additional fields regarding facility reporting requirements for state and federal levels, ensuring compliance with current healthcare data standards.
7. Upon completing the form, review all entries for accuracy and completeness before proceeding to the next steps.
8. Save your changes and select the option to download or print the completed agreement for your records.
9. Return the signed Agreement To Participate to the relevant department as instructed, ensuring it is sent to the Centers for Disease Control and Prevention (CDC) as required.

Start completing your Agreement To Participate online today to ensure your facility's participation in NHSN.