Instructions and Basic Information

Thank you for your participation in the National Association for Behavioral Healthcare (NABH) 2020 Annual Survey.

Completing and Submitting Your Survey:

All of the questions in this survey are targeted toward an individual facility or program whose name and location you will be providing in response to survey question 1.

If you represent an organization responding to the survey on behalf of multiple facilities and programs, please fill out one survey per facility/program. If you need alternate forms for submitting data for multiple facilities of the same organization, please contact us for technical assistance.

The survey can be completed in parts by multiple team members by forwarding the e-mail link provided. Please use the "Previous" button on each page to return to the first page of the survey before forwarding your link.

To save your responses without submitting the survey, you MUST click on the "Next" or "Previous" button on the bottom of the screen.

Once you click "Done" on the last page, your responses WILL be submitted and you will NOT be able to re-enter or modify your submission. For your reference, please print each page of the survey from your web browser prior to submitting your responses.

Complete the NABH 2020 Annual Survey Report based on the operations for your Fiscal Year 2018 (FY 2018). We anticipate that the majority of members will be able to report FY 2018 data. If you have NOT been in operation for a 12-month period, specify the exact dates for which you are providing information.

Please complete the survey with the information you have available. Please ignore questions that do not apply to the facility you are completing this survey for. If you are unable to provide the level of detail that is requested, provide totals or aggregated information.

Please provide written comments or explanations in the comments section at the end of each page, as appropriate.

When entering numbers, please do NOT use commas, decimals, dollar signs, or special characters; round all numbers to the nearest integer.

Confidentiality:
All individual organization data are considered confidential since the e-mail link provided to you is specific to your facility/organization. Do NOT share the survey link with anyone outside of your organization. For added security, this survey website also supports SSL encryption when submitting data responses.

Technical Assistance:
Technical assistance for completing the survey is available by contacting Lorenza West at lorenza.west@dobsondavanzo.com or (757) 802-1283.

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* 1. Facility name:

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* 2. Facility City:

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* 3. Facility Zip Code:

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* 4. Indicate the 12-month reporting dates for FY 2018:

Date
Date

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* 5. Is this facility operated by...(select one only)

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* 6. How many full time employees does your facility have?

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* 7. Comments: Please provide any additional information related to the questions above:

T