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First Name
Last Name
Email
Title
MD
DO
CEO
CFO
COO
Clinic / Office Manager
Physician Extender (PA, NP, etc)
MA
MD or DO Resident
Phone Number
Practice Size
Solo Practitioner
2-5
6-15
16-30
30-50
Over 50
Specialty
Orthopedics
Orthopedics (Foot & Ankle)
Orthopedics (Hand and Upper Extremity)
Orthopedics (Shoulder and Elbow)
Orthopedics (Spine)
Orthopedics (Sports Medicine)
Orthopedics (Total Joint Reconstruction)
Otolaryngology-HNS
Allergy & Immunology
Cardiology
Dermatology
Family Medicine
Internal Medicine
Obstetrics and Gynecology
Ophthalmology
Pain Medicine
Pediatrics
Podiatry
Urology
Electronic Medical Record
AdvanceedMD
AllMeds
AllScripts
Aprima
AthenaClinicals
Centricity
Cerner
ChartLogic
CureMD
DrChrono
eClinicalWorks
Epic
Intergy by Greenway Health
Kareo Clinical
Meditech
Modernizing Medicine
NextGen Healthcare
Practice Fusion
SRS Health
WRSHealth
None
Clinic days per week
.5
1
1.5
2
2.5
3
3.5
4
4.5
5
Average number of patients per day
Which best describes your practice?
Independent Practice Association
Single Specialty Group
Multi-specialty Group
Academic Medical Center
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