* 1. Please complete the following information about yourself and your practice.

* 2. How many providers are in your practice?

* 3. What EHR is your practice using?

* 4. Did you evaluate CIQN?

* 5. What prevented you from joining CIQN?

* 6. Are you satisfied with your EHR?

* 7. Are you aware of the Electronic Health Exchange (eEHX) through CIQN and Children's?

* 8. Would you be interested in connecting with Children's through the eEHX?

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