OMB Number: 0915-0366; Expiration date: XX/XX/202X
Self-Queriers Survey: Module 2
Number of questions: 1
Demographic Information
We are collecting demographic information so that we can learn more about our survey participants.
Q 2.1. In what capacity did you self-query the NPDB?
On My Own Behalf as an Individual Health Care Practitioner
On My Own Behalf as an Individual Health Care Provider, or Supplier
On Behalf of an Organization (Health Care Provider, Supplier, or Entity)
Piping logic:
Depending on the participant’s response above, survey will be directed to the next module as described below (see further details in the survey flowchart):
On My Own Behalf as an Individual Health Care Practitioner Module 3
On My Own Behalf as an Individual Health Care Provider, or Supplier Module 3
On Behalf of an Organization (Health Care Provider, Supplier, or Entity) Module 12
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Microsoft User |
| File Modified | 0000-00-00 |
| File Created | 2021-04-12 |