Ambulatory Care
January 01, 2009

Organization Update Form

Complete Form (Requires Adobe Reader)

Please complete the form to update The Joint Commission on changes in your organization. We must receive this form within 30 days of the change. Type your responses directly on the form, print and send to the address on the bottom of the form. Complete only the sections that apply to the changes you are reporting. Enter your name, sign the form, and mail it to the address at the bottom of the form.

Note:  Accredited Organizations can update contact information directly from the “Update Organization Contacts” link on the “The Joint Commission Connect” extranet website.