Common Clinical Assessment Tool Special Interest Group (CCATSIG)
                        Common Clinical Assessment Tool (CCAT)
                 Nurse Anesthesia Program Registered User Survey

Please complete your responses to the items below to indicate your interest in using the Common Clinical Assessment Tool (CCAT) and becoming a Registered User. You will be contacted by the COA staff in the near future to be invited to attend an orientation/training session regarding the tool and its use. Should you have any questions regarding completing this survey, please contact Susan Schneider at Should you have any questions about the CCAT, please contact Susan Monsen at 

Other Program Contacts to Attend Orientation/Training, Title and Email Address (Provide up to 10 other program contacts):
DescriptionsNameTitleEmail Address
Program Contact 1
Program Contact 2
Program Contact 3
Program Contact 4
Program Contact 5
Program Contact 6
Program Contact 7
Program Contact 8
Program Contact 9
Program Contact 10
Please indicate the format in which the program currently conducts its clinical evaluations. (Select all that apply):
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