Joint Commission Survey

1.	Did you recently, over the past two years, have a Joint Commission survey which included a Life Safety Specialist?
	Yes   No

2.	How would you rank the experience you had with the Life Safety Specialist?
	Excellent Good Fair Poor Complete Disaster

3.	Did you find the Life Safety Specialist knowledgeable about the physical environment, the application of the Environment of Care standards, and understanding of the day-to-day operations of health care facilities?
	Yes   No

4.	How would you rank the level of knowledge of the Life Safety Specialist?
	Excellent Good Fair Poor Complete Disaster

5.	If you had the opportunity to anonymously inform the Joint Commission about your survey experience what would you say (knowing that the survey results are being kept in strict confidence)?

6.	Would you be willing to be interviewed by an ASHE staff member about your experience? (If Yes, Please enter your contact information in the comment box below.)
	Yes   No

7.	Any other comments