Get Survey Vendor Authorization Form - Pqrscahpsorg

Completing the Survey Vendor Authorization Form - Pqrscahpsorg is essential for group practices intending to authorize a survey vendor for the administration of the CAHPS for PQRS Survey. This guide provides a clear and structured process to fill out the form online efficiently and accurately.

Follow the steps to complete the form online.

1. Click the ‘Get Form’ button to access and open the Survey Vendor Authorization Form - Pqrscahpsorg in the online editor.
2. In the designated field, print the name of the designated survey administrator clearly. This person will serve as the CAHPS for PQRS Survey Administrator for the group practice.
3. Next, input the name and ID of the group practice for which you are authorizing the vendor. If multiple practices are involved, print ‘see attached list of [insert number] group practices’ in the space provided.
4. In the responsibilities section, confirm your acknowledgment of the responsibilities of the CAHPS for PQRS Survey Administrator role by reading the terms and signing where indicated.
5. Complete the contact information fields, including first and last name, title, phone number, email address, and mailing address for the group practice administrator.
6. Fill in the details of the backup administrator and the authorized survey vendor, ensuring all names and addresses are accurately provided.
7. Arrange for notarization of the completed form, ensuring that both your signature and the notary public's seal are affixed appropriately.
8. Finally, review all entered information for accuracy, save the changes, and decide whether to download, print, or share the form as needed.

Start your process to complete and submit the Survey Vendor Authorization Form online today.