This free survey is powered by
0%
Exit Survey
 
 
Hello:
You are invited to participate in our survey [Project Description Here]. In this survey, approximately [Approximate Respondents] people will be asked to complete a survey that asks questions about [General Survey Process]. It will take approximately [Approximate Time] minutes to complete the questionnaire.

Your participation in this study is completely voluntary. There are no foreseeable risks 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 Continue button below.

 
 
 
 
* Are you a practicing physician?
 
Yes
 
No
 
Retired
 
 
 
* What is your board certification?
 
Dermatology
 
Otolaryngology
 
General Surgery
 
Plastic Surgery
 
Other
 

 
 
 
Since the end of residency/fellowship, how many years have you been in practice?
 
0-5
 
6-10
 
11-15
 
16-20
 
20+
 
 
 
Did you complete fellowship training?
 
Yes
 
No
 
 
 
What type(s) of fellowship training did you complete?
 
No fellowship
 
Procedural dermatology- ACGME accredited
 
Mohs surgery- ACMS accredited
 
Independent dermatologic, cosmetic, or laser
 
ENT facial plastic surgery
 
Plastic surgery
 
Other
 

 
 
 
What was the total length of your fellowship training?
 
1 year
 
2 years
 
3 years
 
4 years
 
5+years
 
No post-residency fellowship
 
Other
 
 
 
 
Do you perform office-based surgical procedures?
 
Yes
 
No
 
 
 
On an average week, how much time do you dedicate to office based procedures?
 
0-1 days
 
2-2.5 days
 
3-3.5 days
 
4-4.5 days
 
5+ days
 
 
 
What kind of procedures do you perform in the office (under local or tumescent anesthesia)?
 
Excision
 
Mohs micrographic surgery
 
Flaps
 
Grafts
 
Botox
 
Fillers
 
Dermabrasion
 
etc