Office Site and Medical Record Evaluation Forms

Office Site and Medical Record Evaluation Forms

Last Updated: Friday, September 16, 2022

Quality management nurses conduct practitioner office site quality and medical/treatment record evaluations for any practitioner within its network based on:

  • Member dissatisfactions relating to physical accessibility, physical appearance, and adequacy of waiting and/or examination-room space.
  • Annual random sampling: Using a statistically valid sampling methodology, practice sites will be selected to have practitioner office site quality and medical/treatment record evaluations performed.

For your convenience, provided below are copies of the forms.