
INDEPENDENT HEALTH FACILITIES FACILITY PRE-ASSESSMENT QUESTIONNAIRE DIAGNOSTIC IMAGING NOTE: This document must be prepared/completed by the most responsible person involved in the day-to-day activities.
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How to fill out the Canada CPSO Facility Pre-Assessment Questionnaire online
The Canada CPSO Facility Pre-Assessment Questionnaire is a crucial document that must be filled out accurately by the person responsible for day-to-day operations in the facility. This guide provides you with a comprehensive overview of how to complete this form online, ensuring that you submit all necessary information correctly.
Follow the steps to accurately complete the questionnaire.
- Press the ‘Get Form’ button to access the questionnaire and open it in your preferred online document editor.
- Begin by providing the facility details, including the name, billing number, mailing address, and contact information. Ensure all information is complete and accurate.
- Indicate the hours of operation and detail whether the facility has separate areas for patient waiting, change rooms, washrooms, procedure rooms, image storage, and processing areas. Select 'Yes', 'No', or 'N/A' accordingly.
- Confirm the wheelchair accessibility of the facility and specify the location where the IHF License is posted.
- List the services your facility is licensed to perform, indicating whether all services are operational. If not, specify which ones are not currently being provided.
- For mobile diagnostic facilities, provide information specific to each location, indicating how frequently the site is visited and the types of examinations conducted.
- Complete the staff section by listing the names and roles of quality advisors and radiation protection officers. Attach any signed agreements as directed.
- Fill out the training and certification table, documenting all staff members' qualifications and relevant training certifications with corresponding dates.
- Ensure to provide detailed answers regarding policies and procedures, infection control, equipment maintenance, and quality assurance processes as specified in the questionnaire.
- Review your responses for accuracy and completeness. Once satisfied, use the options to save changes, download, print, or share the completed form as needed.
Begin completing the Canada CPSO Facility Pre-Assessment Questionnaire online to ensure your facility meets all necessary standards.
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