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Pre-Activity Survey
Demographics
1.
What is your profession?
Physician
Physician Assistant
Nurse
Nurse Practitioner
Pharmacist
Other (please specify)
2.
My practice setting is...
Private Practice
Hospital
Clinic
Long-Term Care Facility
VA
Other (please specify)
3.
The number of years I have been in practice is:
<5 years
5–10 years
11–15 years
15-25 years
>25 years
4.
The average number of patients I see each week is:
<20
20–50
51–100
>100
5.
Approximately what percent of your patients have signs and symptoms related to overactive bladder (OAB)?
<10%
10% to 25%
26% to 50%
>50%
Not sure
6.
How confident are you in managing your patients with OAB with the following treatments?(Scale of 1 to 5; 1 = not at all confident; 5= very confident)
Not at all Confident
2
3
4
Very Confident
Behavioral therapy
Not at all Confident
2
3
4
Very Confident
Antimuscarinics
Not at all Confident
2
3
4
Very Confident
Beta3-agonists
Not at all Confident
2
3
4
Very Confident
Botulinum toxin
Not at all Confident
2
3
4
Very Confident
Combination therapy
Not at all Confident
2
3
4
Very Confident
