D.30 PAST PERFORMANCE QUESTIONNAIRE.rtf

This document is a past performance questionnaire template for a contractor providing emergency medicine physician services. The Department of Veterans Affairs, G.V. (Sonny) Montgomery VAMC in Jackson, MS is seeking these services for eligible Veterans in Jackson and surrounding counties. The contractor will furnish healthcare providers, medical facilities, equipment, supplies, and administrative functions to support enrolled patients. The past performance questionnaire requests information on the contractor's performance on a prior contract, including compliance, timeliness in filling requirements, quality of physicians, ability to handle changes, and communication and contract management. Respondents are asked to rate these performance areas as excellent, good, satisfactory, marginal, or unsatisfactory and provide any relevant details or explanations. The completed questionnaires must be returned by October 26, 2023 to Troy Davis at troy.davis@va.gov.