This survey should take approximately 10-15 minutes to complete. For your time, your name will be placed in a raffle to receive a $100 AMAZON gift card. Two (2) winners will be chosen. Winners will be notified on April 25, 2017.     

Thank you in advance for your time and cooperation!

Please note:

1.  We are using the following definition to describe “chronic condition”: 
“Conditions that last a year or more and require ongoing medical attention and/or limit activities of daily living.”

2. Questions with an asterisk (*) require a response (in order to proceed to the next question).

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Not at all confidentSlightly confidentSomewhat confidentConfidentVery confident
Communicating with professional disciplines outside of your practice
Gathering information with the use of a standardized assessment tool
Making initial medication selections
Performing functional assessments of patients
Prescribing adjuvant medications or therapies to a current regimen
Tapering medications
Writing complete referral notes to the specialist
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If you are interested in participating in the raffle for a $100/€100 Amazon gift card, please fill out the following: