OMB Number: 0915-0366; Expiration date: XX/XX/202X
Entities Survey: Module 7
Number of questions: 10
This module is relevant for the following entity identified in Module 2:
Federal or State Prosecutor (including Attorney General)
Demographics Related Questions
Q 7.1. For the typical year, how many cases does your office prosecute?
Type a number: __________
Do not know (Please Explain) ________
Q 7.2. For the typical year, how many cases does your office settle?
Type a number: __________
Do not know (Please Explain) ________
Q 7.3. For the typical year, how many health care related cases that are potentially reportable to the NPDB does your office prosecute?
Type a number: __________
Do not know (Please Explain) ________
Q 7.4. For the typical year, how many health care related cases in your office that are potentially reportable to the NPDB are settled?
Type a number: __________
Do not know (Please Explain) ________
Q 7.5. For the typical year, approximately how many of the health care related cases in your office that are potentially reportable to the NPDB result in a conviction?
Type a number: __________
Do not know (Please Explain) ________
Survey Page Break
Q 7.6. How many total staff members within your office support casework?
Type a number: __________
Do not know (Please Explain) ________
Q 7.7. Who is responsible for reporting to the NPDB?
My Organization
Other Federal Agency (Please Specify) _________
Other State Agency (Please Specify) _________
Other (Please Explain) ___________
Q 7.8. Does your office report any health care related cases to the NPDB?
Yes
No
Do not know
Report to a different Federal agency (Please Specify) ___________
Report to a different State agency (Please Specify) ___________
Q 7.9. How many cases have you reported to the NPDB in the last 5 years?
Dropdown menu: 0 to 100
Survey Page Break
Q 7.10. Were you aware of the NPDB’s reporting requirements before this survey?
Yes
No
Piping Logic:
Survey will be directed to Module 8 next.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Microsoft User |
| File Modified | 0000-00-00 |
| File Created | 2021-04-12 |