Member MTM Survey

 

1. Are you currently a member of the Tennessee Pharmacists Association?

Are you currently a member of the Tennessee Pharmacists Association?   Yes No

2. How many years have you been in practice as a pharmacist?

How many years have you been in practice as a pharmacist?   1-5 years 6-10 years 11-15 years 16-20 years over 20 years

3. What is your current age?

What is your current age?   20-30 years 31-40 years 41-50 years above age 50

4. Please choose the category that best describes your current practice site:

Please choose the category that best describes your current practice site:   Retail independent pharmacy Retail chain pharmacy In-patient hospital pharmacy Out-patient hospital pharmacy LTC pharmacy HMO/PBM Consultant Academic Government facility Mail-Order facility

Other (please specify)

5. What is your position at this practice site?

What is your position at this practice site?   Owner Manager Pharmacy Director Staff Pharmacist Clinical Pharmacist Faculty

Other (please specify)

6. Including yourself, how many pharmacists work concurrently (i.e. on duty at the same time) at your practice site?

Including yourself, how many pharmacists work concurrently (i.e. on duty at the same time) at your practice site?   One pharmacist 2-3 pharmacists 4 or more pharmacists

7. What is the average daily prescription volume at your practice site?

What is the average daily prescription volume at your practice site?   <100 100-199 200-299 300-399 400-499 500 or more Not Applicable

8. Do you personally conduct formal Medication Therapy Management (MTM) services at this practice site?

Do you personally conduct formal Medication Therapy Management (MTM) services at this practice site?   Yes No