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* 1. Please provide your name.

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* 2. What is your role in the practice?

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* 3. If selected, will you lead this project for the practice?

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* 4. If no, who will lead this project (please provide name and role)?

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* 5. What is the name of the pediatrician responsible for this project?

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* 6. How many providers are at your practice?

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* 7. Who in your practice is responsible for making social media posts/managing current social media accounts?

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* 8. What, if any, social media accounts does your practice currently use?

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* 9. What social media platforms would you plan to use for this learning collaborative? Please indicate if the account already exists or if it would be new.

  Already exists New Won't use
Facebook
Twitter
Instagram

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* 10. Approximately what percentage of your followers are parents/families

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* 11. What is the nature of the posts your practice makes on social media (eg, practice-specific updates or educational information from the AAP, CDC, etc.?

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* 12. What are your goals? What do you want to accomplish by participating in this pilot?

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* 13. Please provide your email address.

0 of 13 answered
 

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