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Hematology Therapies: Identifying Best Practices and Gaps in Care
Multiple Myeloma and Acute and Chronic Leukemia Needs Assessment Questionnaire
Demographics
*
1. Please indicate your preferred languages
(Required.)
English
French
*
2. Please indicate the province or territory in which your practice is based:
(Required.)
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Nova Scotia
Northwest Territories
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
*
3. Please indicate your specialty:
(Required.)
Hematologist
Medical oncologist
Oncology nurse practitioner
Oncology nurse (part-time or full-time)
Oncology pharmacist (part-time or full-time)
Other (please specify)
*
4. What is your main affiliation?
(Required.)
Academic (university, teaching hospital)
Community-based (private practice, clinic, tertiary hospital, retail pharmacy)
Other (please specify)
*
5. For how many years have you been in practice?
(Required.)
≤ 5
6-10
11-15
> 15
Multiple Myeloma
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1. Do you treat or see patients with multiple myeloma?
(Required.)
Yes
No