ASPHO SurveyASPHO Survey

1. I have used a search engine (Google, Bing, Yahoo!) to search for a hospital to refer one of my patients

	1 - Strongly disagree	2 - Agree	3 - Indifferent	4 - Agree	5 - Strongly Agree
Please indicate which of the following statements are true by scoring them on a scale of 5 down to 1 (i.e. 5 = Strongly agree; = Strongly Disagree)	*I have used a search engine (Google, Bing, Yahoo!) to search for a hospital to refer one of my patients Please indicate which of the following statements are true by scoring them on a scale of 5 down to 1 (i.e. 5 = Strongly agree; = Strongly Disagree) 1 - Strongly disagree	Please indicate which of the following statements are true by scoring them on a scale of 5 down to 1 (i.e. 5 = Strongly agree; = Strongly Disagree) 2 - Agree	Please indicate which of the following statements are true by scoring them on a scale of 5 down to 1 (i.e. 5 = Strongly agree; = Strongly Disagree) 3 - Indifferent	Please indicate which of the following statements are true by scoring them on a scale of 5 down to 1 (i.e. 5 = Strongly agree; = Strongly Disagree) 4 - Agree	Please indicate which of the following statements are true by scoring them on a scale of 5 down to 1 (i.e. 5 = Strongly agree; = Strongly Disagree) 5 - Strongly Agree

2. Information I find on a hospital’s website influences my decision on whether to make a referral

	1 - Strongly disagree	2 - Disagree	3 - Indifferent	4 - Agree	5 - Strongly agree
Please indicate the true statement	*Information I find on a hospital’s website influences my decision on whether to make a referral Please indicate the true statement 1 - Strongly disagree	Please indicate the true statement 2 - Disagree	Please indicate the true statement 3 - Indifferent	Please indicate the true statement 4 - Agree	Please indicate the true statement 5 - Strongly agree

3. I only refer to hospital/physicians with whom I have an established relationship

	1 - Strongly disagree	2- Disagree	3 - Indifferent	4 - Agree	5 - Strongly agree
Please indicate the true statement	*I only refer to hospital/physicians with whom I have an established relationship Please indicate the true statement 1 - Strongly disagree	Please indicate the true statement 2- Disagree	Please indicate the true statement 3 - Indifferent	Please indicate the true statement 4 - Agree	Please indicate the true statement 5 - Strongly agree

4. I do not use the web to search or research referring hospitals

	1 - Strongly disagree	2 - Disagree	3 - Indifferent	4 - Agree	5 - Strongly agree
Please indicate the true statement	*I do not use the web to search or research referring hospitals Please indicate the true statement 1 - Strongly disagree	Please indicate the true statement 2 - Disagree	Please indicate the true statement 3 - Indifferent	Please indicate the true statement 4 - Agree	Please indicate the true statement 5 - Strongly agree

5. I use social media to network with other professional or experts in my field

	1 - Strongly disagree	2 - Disagree	3 - Indifferent	4 - Agree	5 - Strongly Agree
Please indicate the true statement	*I use social media to network with other professional or experts in my field Please indicate the true statement 1 - Strongly disagree	Please indicate the true statement 2 - Disagree	Please indicate the true statement 3 - Indifferent	Please indicate the true statement 4 - Agree	Please indicate the true statement 5 - Strongly Agree

6. If you use social media to network with other professionals, which ones do you use

If you use social media to network with other professionals, which ones do you use Linked-In

Facebook

Twitter

Other

7. What website(s) do you visit to get the latest medical information?

What website(s) do you visit to get the latest medical information?

8. Please enter the following information:

Please enter the following information: First Name:
Last Name:
Email Address:

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