Clinicians
Thank you for your interest in assisting us with this project. Please answer the following questions. The information gathered will be used to identify 4-8 clinicians to interview during the week of October 24th. This screener should take 5-10 minutes of your time. If selected, your contact information will be used to schedule a time to speak with you. If you have any questions, you can reach out to: carly@adg.design
Sign in to Google to save your progress. Learn more
Screener
What is your name?
What is your email address?
What is your title?
What is your role?
Clear selection
What is your medical specialty?
What is the name of your institution?
How is the area where you practice classified?
Clear selection
How many years of experience do you have in active clinical practice since completion of your professional training?
Clear selection
What percentage (%) of your professional time is spent doing the following activities:
0-25%
25-50%
50-75%
75-100%
Direct patient care
Research
Administrative activities
Other
Clear selection
In an average month, what percentage of the patients you manage have COPD?
Clear selection
In which region of the US are you located?
Clear selection
Do you have experience using remote patient monitoring? If yes, explain
Do you see an advantage in early COPD exacerbation detection? If yes, explain
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy