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Choose your clinical provider type
 
Physician
 
Physician Assistant
 
Nurse Practictioner
 
Mental Health Provider
 
Other
 
 
 
 
Select your clinical practice
 
Primary Care
 
Specialty Care
 
Other
 
 
 
 
Select your gender
 
Female
 
Male
 
Other
 
 
 
 
Select your age group
 
less than 30 years
 
30 - 39 years
 
40 - 49 years
 
50 - 59 years
 
60 - 69 years
 
Over 70
 
 
 
How many years have you been using Electronic Health Records?
 
1 - 3 years
 
4 - 6 years
 
7 - 10 years
 
More than 10 years
 
I do not use Electronic Health Records
 
 
 
How often do you practice in direct patient care?
 
Not at all
 
Less than 25% time
 
25 - 50% of the time
 
More than 50 % of the time
 
 
 
Q1: How likely are you to complete documentation during the patient visit?
 
Not at all likely
 
A little likely
 
Moderately likely
 
Mostly likely
 
Extremely likely
 
 
 
Q2. How likely are you to discuss content of clinical documentation during the vist with the patient?
 
Not at all likely
 
A little likely
 
Moderately likely
 
Mostly likely
 
Extremely likely
 
 
 
Q3. How likely are you to show the patient your clinical note during the visit?
 
Not at all likely
 
A little likely
 
Moderately likely
 
Mostly likely
 
Extremely likely
 
 
 
Q4. If you create the note after the visit, how likely is/are your patient(s) able to understand your instructions?
 
Not at all likely
 
A little likely
 
Moderately likely
 
Mostly likely
 
Extremely likely
 
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