It is important to collaborate and share information on a consistent basis to allow for the best outcomes of the youth served through the Regional Service Coordination model. Although we send provider specific surveys and encourage open communication between the CSU/CAP and EBA, this form provides a structure for ongoing feedback and continuous quality improvement efforts. Information submitted here can be shared with the EBA team, DJJ QA, and providers as appropriate. Feedback that require additional oversight or interventions can also be tracked and resolved. Please complete this form to: