You are here: Skip Navigation LinksDatabases > Upload DUA


Nursing Home Survey on Patient Safety Culture DUA Submission Portal

Data Use Agreement

Each Nursing Home or System/Chain wishing to participate in the Nursing Home Survey on Patient Safety Culture Database is required to sign a Data Use Agreement (DUA) each submission period. The DUA assures the confidentiality of the data and explains how the data will be used. The completed and signed DUA can be submitted at any time. The DUA can be uploaded directly to the submission system through the DUA submission portal, emailed to DatabasesOnSafetyCulture@westat.com, or faxed to 1-888-852-8277.

Nursing Home Survey on Patient Safety Culture Data Use Agreement (PDF, 142 KB, PDF HELP)

For technical assistance, please email DatabasesOnSafetyCulture@westat.com or call 1-888-324-9790.