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AHRQ: Agency for Healthcare Research and Quality

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DatabasesOnSafetyCulture@westat.com

OMB Control Number: 0935-0196
Expiration Date: 9/30/2024



SOPS Medical Office Survey Eligibility Form

We welcome your interest! To determine your organization's eligibility for participation in the SOPS Medical Office Survey Database, we need to collect some information about you and your survey.

A field with an asterisk (*) before it is a required field.
* 1. Which of the following do you represent?




   
* 2. Will you have completed survey data collection and be able to submit your final electronic data file
        by September 22, 2023?

     
*
     
* 4. Have you used the Action Planning Tool for the AHRQ Surveys on Patient Safety Culture®?

   
* 5. Did you administer the SOPS Diagnostic Safety Supplemental Items with your SOPS Medical Office Survey?

   
*6. Did you administer the SOPS Value and Efficiency Supplemental Item Set with your SOPS Medical Office Survey?

   
* 7. Did you make any changes to the SOPS Medical Office Survey with/without supplemental items?