Sample_Bereavement_Survey_Intro_second_Letter_.pdf

DEPARTMENT OF VETERANS AFFAIRS

Medical Center 3900 Woodland Avenue Philadelphia, PA 19104

«ID Number» «Date» «FirstName» «LastName» «Address1» «Address2» «City», «State» «Zip»

Dear «Name» «Last Name», I am writing to you to express my condolences on the loss of «Vet_First» «Vet_Last» «Vet_Suffix». A few weeks ago, you received an invitation to participate in a survey for the Department of Veterans Affairs. We are aware that this is a very difficult time for you; but we need your support in order to improve the care we provide to our Veterans.

Ensuring high quality healthcare for Veterans is central to the VA mission, but we can only do this if our Veterans’ friends and family members tell us what we did well and what we could have done better.

Your opinions are very important to us. However, we have not received your completed survey yet. If you have already completed the survey and sent it to us, thank you. If you have decided not to participate in the survey, I ask you to reconsider.

Although the survey is voluntary, we need your suggestions and comments to inform us about what we have done well and what we could have done better. A pre-addressed, stamped envelope is included for your convenience.

You may also complete the survey online.

To access the survey online:

Log on to https://www.research.net/r/InpatientM?ID=«MergeID» Enter your password: «MergeID»

If you prefer to complete the survey over the phone, please call the Veteran Experience Center toll-free at 1-877-503- 5817 and reference #«MergeID». If you feel you are not the person who is best able to answer questions about the care «Vet_First» «Vet_Last» «Vet_Suffix» received in the last month of life, please call us with the name, address, and phone number of the person who may be better able to answer these questions. If you received this letter in error, please call us so that we may correct our records.

If you would like to speak to someone about benefits or other resources, you may call the VA Office of Survivors Assistance at 202-461-1077.

Thank you for your time and commitment to our Nation’s Veterans.

Sincerely, Scott T. Shreve, DO Corporal Michael J. Crescenz VAMC - Philadelphia

Usted ha recibido esta carta del Departamento de Asuntos para Veteranos en relación a una encuesta acerca del cuido recibido por «Vet_First» «Vet_Last» «Vet_Suffix» en el Hospital de Veteranos en su último mes de vida. Por favor si desea recibir más información en español comuníquese con nosotros al 1-877-503-5817 y refiérase al número #«MergeID».

THE OFFICE OF MANAGEMENT AND BUDGET HAS APPROVED THIS SURVEY UNDER OMB NUMBER 2900-0701 IN ACCORDANCE WITH SECTION 3507 OF THE PAPERWORK REDUCTION ACT OF 1995. WE ESTIMATE THAT IT WILL TAKE ABOUT 10 MINUTES TO ANSWER THESE QUESTIONS. YOUR RESPONSES WILL BE USED TO MEASURE VETERANS’ AND FAMILIES’ PERCEPTIONS OF THE HEALTHCARE VA PROVIDES. YOUR PARTICIPATION IS VOLUNTARY AND CONFIDENTIAL. IF YOU CHOOSE NOT TO PARTICIPATE, IT WILL NOT AFFECT

YOUR BENEFITS IN ANY WAY.

https://www.research.net/r/InpatientM?ID=