Conflict Resolution Form

Lets medical practice staff assess how often they face difficult patient interactions and gauge whether a dedicated conflict resolution protocol would be useful.

Use this template

How Many Times a Month Do You Encounter a Patient with an Aggressive Manner?

Never 1–2 Times 3–5 Times More than 5 Times

Do You Think a Practice-Specific Conflict Resolution Action Plan Would Be Useful?

Yes No

If You Have Any Further Comments or Suggestions on How We Can Develop a Good Conflict Resolution Action Plan for the Practice, Please Write Them Below. Thank You.

	Column 1	Column 2	Column 3
Row 1
Row 2

Conflict Resolution Form

Related templates