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Provider Questionnaire

The Nursing Home Guide questionnaire allows providers the opportunity to enter informations about a facility and its services.

Once this information has been entered, Nursing Home Guide visitors will be able to search for that facility by its services.

To complete, download the questionnaire, using the link below, and return by mail or by fax. (Note - the questionnaire form is in PDF format — you will need to use Adobe's free Acrobat Reader program in order to print it out.)

In the future, facilities will be able to manage their questionnaire data, directly, via this web-page.

leafGraphic  download provider questionnaire


California Advocates for Nursing Home Reform (CANHR)
1610 Bush Street San Francisco, CA 94109
(800) 474-1116 (Consumers only, please)  |  (415) 474-5171

Modified: Page Last Modified: Monday, September 19, 2005 9:02 AM email us   
© 2002 by California Advocates for Nursing Home Reform

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