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2016
August
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Exit Survey
Dear Doctor:
You are invited to participate in our survey for the Cardiology Today Spotlight Supplement. In this survey, approximately 100 people will be asked to complete a survey that asks questions about TOPIC HERE].
It will take approximately 5 minutes to complete the questionnaire.
Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn your opinions. Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential.
If you have questions at any time about the survey or the procedures, you may contact [Name of Survey Researcher] at [Phone Number] or by email at the email address specified below.
Thank you very much for your time and support.
Please start with the survey now by clicking on the
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button below.
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Do you recall receiving the supplement?
Yes
No
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How thoroughly did you read the supplement?
Read some
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Skimmed
Intend to read
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How likely are you to incorporate the information provided in this supplement into your practice?
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Please rate below: 1 star= Not Likely, 5 stars= Very Likely
Please rate the following statements regarding this supplement:
Strongly Disagree
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Neutral
Agree
Very Much Agree
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I found that the supplement was extremely informative on the topic of lorem ipsum dolor.
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The overall content of the supplement is excellent.
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After receiving this supplement, I have a stronger understanding on the use of the lorem ipsum dolor for lorem ipsum dolor.
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I would be interested in receiving more information on the topics covered in this supplement.
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How many years have you been in practice?
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Less than 1 year
1-5 years
6-10 years
11-5 years
More than 15 years
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Would you like to receive future educational content in this format?
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What topics would you like to see covered in future educational programs?
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