Otolaryngology Needs Assessment Questionnaire

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Thank you for taking the time to complete our Otolaryngology Needs Assessment Questionnaire for Family Physicians practicing in Alberta. Your responses will help develop standardized templates to promote efficient and effective patient triaging in otolaryngology.

Your responses will be anonymous and your information will not be collected.

There are 3 questions. Each will take only 3-5 minutes.

If you have any questions, please feel free to contact Dr. Julianna Zenke, at zenke@ualberta.ca

What is your medical specialty? *

Family Medicine

Other:

Please list the top 5 most frequent otolaryngology presentations to your clinic

Of the above presentations, which two would you find most useful to have a referral template for and why? (1/2)

Of the above presentations, which two would you find most useful to have a referral template for and why? (2/2)

If you are interested in having further discussions about this template development, please put your email in below

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