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How interested are you in participating in a practice change based upon the latest best practice guidelines?
 
Very interested
 
Interested
 
Neutral
 
Uninterested
 
Uninterested
 
Very uninterested
 
 
Please rate the following features  based on their importance to you.
Very Important Somewhat Disagree Neutral Somewhat Important Very Important
Broadening your knowledge base
Free education
Professionalism
Customer service
Employee satisfaction
 
 
 
Do you feel that the information presented to you regarding this practice change is clear?
 
Completely disagree
 
Somewhat disagree
 
Slightly disagree
 
Neutral, Slightly agree
 
Somewhat agree
 
Completely agree
 
 
 
Based on the timeline presented, how do you feel regarding the degree of difficulty of this practice change process?
 
Extremely
 
Very
 
Moderately
 
Slightly
 
Not at all
 
 
 
Do you feel well prepared to implement this practice change?
 
Extremely
 
Very
 
Moderately
 
Slightly
 
Not at all
 
 
 
Please provide any additional comments you have about our proposed service.
   
 
I truly appreciate your time and effort towards implementing this practice change to allow the best care for our patients!!!!