Form 26 Prospective Clinical Trial Survey

Attachment_7_prospectivesurvey

Note: Q1a appears only if “My practice is located within a community hospital” is selected for Q1.

If user selects “physician” to Q3, continue below. If user selects “Staff member/other”, continue HERE.

Note: This 8a appears if the user selects either of the two leftmost radio buttons for Q8.

Note: This Q8a appears if the user selects any of the three rightmost radio buttons for Q9.

END OF SURVEY

Note: Q1a appears only if “My practice is located within a community hospital” is selected for Q1.

Note: This QS2 appears if the user selects either of the two leftmost radio buttons for QS2.

Note: This QS2 appears if the user selects any of the three rightmost radio buttons for QS2.