OBRI Site Survey

Investigator*
First Last
Do you have a hospital affiliation? If yes, please specify which hospital(s) under OTHER.*
- Yes
- No
Do you use an electronic medical record in your practice? If yes, please specify which EMR under OTHER.*
- Yes
- No
Who triages the patients in your practice?*
In your rheumatology practice, do you have access to:*
- ACPAC therapist (currently and during the past 2 years)
- ACPAC therapist (in past 2 years but not currently)
- ACPAC therapist (more that 2 years ago)
- Nurse (currently and during past 2 years)
- Nurse (in past 2 years but not currently)
- Nurse (more that 2 years ago)
- Other - please specify in the comment box below
Thank you for taking the time to complete this brief survey. Please use the space below if you have any further comments/questions/clarifications.