Profiling Survey for Practitioners

1. What is your profession?
Medical Physician
Osteopathic Physician
Chiropractic Physician
Podiatric Physician
Advanced Registered Nurse Practitioner

2. Was the online profiling update system easy to access?
Yes
No

If not, please provide details.

3. Was the online profiling update system easy to use and navigate?
Yes
No

If not, please provide details.

4. Was any information missing from your profile that you previously reported to the Department of Health?
Yes
No

If so, please provide details.

5. Was any incorrect information listed in your profile?
Yes
No

If so, please provide details.

6. What resource did you use to access the online practitioner update application?
Personal desktop or laptop computer
Personal Smart phone (i.e., iPhone, Droid)
Work computer
Public library computer
University computer
Internet café, cybercafé or internet kiosk
Not Applicable
other:

For the following statement, please select the word(s) that most closely indicate(s) your level of agreement or disagreement with the statement.

7. Overall, I'm satisfied with the online profiling update system.
Strongly Agree
Agree
Disagree
Strongly Disagree

8. How can we improve the online profiling update system?

Please provide the following information in case we need to contact you regarding any missing or inaccurate information on your profile:

License Number

Your name

E-mail Address

Daytime Telephone Number (including area code)