www.hpmi.org 2015 Needs Assessment 1. Needs Assessment Please fill out this survey to aid tailored education planning. * 1. Name * 2. Your Practice * 3. Email * 4. I am a GP Registrar General Practitioner Practice Nurse Practice administrator (please specify below) Nurse Allied Health (please specify below) Specialist (please specifiy below) Please specify Pleave turn to next page * 5. Please indicate which speciallties you would be interested in HPMI covering in 2015 Interested Addiction Medicine Addiction Medicine Interested Cardiology Cardiology Interested Dermatology Dermatology Interested Endocrinology Endocrinology Interested Emergency Medicine Emergency Medicine Interested Evidence Based Medicine Evidence Based Medicine Interested Gastroenterology Gastroenterology Interested Genetics Genetics Interested Geriatrics Geriatrics Interested Haematology Haematology Interested Infectious Disease Infectious Disease Interested Intensive Care Medicine Intensive Care Medicine Interested Immunology & Allergy Immunology & Allergy Interested Men's Health Men's Health Interested Mental Health Mental Health Interested Muscles and Joints Muscles and Joints Interested Nephrology Nephrology Interested Neurology Neurology Interested Obstetrics and Gynaecology Obstetrics and Gynaecology Interested Occupational Medicine Occupational Medicine Interested Oncology Oncology Interested Ophthalmology Ophthalmology Interested Oral Maxillofacial Surgery Oral Maxillofacial Surgery Interested Orthopaedics Orthopaedics Interested Paediatrics Paediatrics Interested Pain Medicine Pain Medicine Interested Palliative Medicine Palliative Medicine Interested Pathology Pathology Interested Pharmacology Pharmacology Interested Public Health Public Health Interested Radiology Radiology Interested Respiratory Respiratory Interested Rehabilitation Medicine Rehabilitation Medicine Interested Rheumatology Rheumatology Interested Technology Technology Interested Please turn to next page for more Specialties * 6. Please indicate which speciallties you would be interested in HPMI covering in 2015 Interested Men's Health Men's Health Interested Sexual Health Sexual Health Interested Sleep Medicine Sleep Medicine Interested Sports Medicine Sports Medicine Interested Surgery Surgery Interested Urology Urology Interested Vascular Vascular Interested Women's Health Women's Health Interested Wound Care Wound Care Interested * 7. Please provide specific topics for specialties you are interested in * 8. List any other specialties or topics Done
