CORNET ENROLLMENT SURVEY v4.19.2011

 

Welcome to the CORNET Enrollment Survey. This is a 2-part questionnaire; part A refers to your institution, residency program and contact information, and part B refers to the registration of your clinical practice site. If you are enrolling more than one practice site from your training program, we ask that you please repeat all the appropriate and pertinent contact information for each of the additional sites in the latter portion of the questionnaire.

This questionnaire needs to be completed at one time, due to software constraints. Thus, you will want to review this form and gather the requested information regarding your residents (types, numbers, etc.) and practice population (racial and ethnic distribution, insurance distribution, etc.) prior to initiating data input. Thank you!