PO EQA Application Form
Please fill out this form as thoroughly as possible, as it will help us determine eligibility of new labs and their commitment to improving and sustaining quality. 
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Email *
Name of Applicant  *
Hospital or Institution Name  *
Laboratory Name *
Department Name (enter N/A if not applicable) *
City *
Country *
Telephone *
Lab Director/Manager Name *
Lab Director/Manager Email *
What is your role in the laboratory? *
In addition to your position, what other leadership roles are in your lab?  *
Required
Laboratory Affiliation (check all that apply) *
Required
Laboratory Level *
Areas within your lab (check all that apply) *
Required
To the best of your knowledge, how many tests does your lab perform monthly?
 *
For your most commonly ordered tests, how often do you perform internal quality control (QC)? *
Have you ever participated in an EQA program before? *
If yes, please share your most significant challenges with the previous EQA program. If no, write "N/A" *
Why are you interested in EQA? Please list at least 3 reasons.  *
What EQA program are you PRIMARILY interested in?  *
What other EQA program are you interested in?  *
Describe at least 2 measures you have undertaken to improve quality in your laboratory in the past year. *
How did you hear about Pathologists Overseas? *
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