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Patient and Family Advisory Council for Quality and Safety (PFA CQS) Questionnaire
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Email Address:Phone:Mailing Address:
City:State:Zip Code:Please tell us about your experience
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How to fill out patient and family advisory

How to fill out patient and family advisory
01
Start by gathering all the necessary information about the patient and their family.
02
Begin by filling out the basic details such as the patient's name, date of birth, and contact information.
03
Provide a section to fill out the medical history of the patient, including any previous surgeries, allergies, or chronic conditions.
04
Include a space to document the family's medical history, as this can often be relevant to the patient's health.
05
Allow for a space to note any specific concerns or feedback the patient or their family may have about their healthcare experience.
06
Provide clear instructions on how to submit the completed advisory form or whom to contact with any questions.
07
Make sure to keep the patient's and family's information confidential and secure throughout the entire process.
Who needs patient and family advisory?
01
Patient and family advisory is beneficial for healthcare organizations that value patient-centered care.
02
It is especially important for hospitals, clinics, and other medical facilities that want to involve patients and their families in decision-making processes.
03
Healthcare providers who aim to improve the overall patient experience can benefit from implementing patient and family advisory.
04
Patients and their families who wish to actively participate in their healthcare journey can utilize this advisory to express their opinions, concerns, and suggestions.
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