How many years have you been a licensed pharmacist?

Question Title

* 1. How many years have you been a licensed pharmacist?

Current practice site 

Question Title

* 2. Current practice site 

What board certification have you obtained? (check all that apply)

Question Title

* 3. What board certification have you obtained? (check all that apply)

In your practice do you utilize theĀ Pharmacist Patient Care Process (PPCP):

Question Title

* 4. In your practice do you utilize theĀ Pharmacist Patient Care Process (PPCP):

Do you have a collaborative practice agreement protocol at your practice site?  If yes, then please complete the rest of the survey

Question Title

* 5. Do you have a collaborative practice agreement protocol at your practice site?  If yes, then please complete the rest of the survey

Which tasks are you allowed to perform within the CPA regarding drug therapy? (Check all that apply)

Question Title

* 6. Which tasks are you allowed to perform within the CPA regarding drug therapy? (Check all that apply)

Which disease states or areas of care are included in your protocol?

Question Title

* 7. Which disease states or areas of care are included in your protocol?

How many pharmacists in your practice areas are involved in the CPA?

Question Title

* 8. How many pharmacists in your practice areas are involved in the CPA?

How many providers are involved in the CPA?

Question Title

* 9. How many providers are involved in the CPA?

Which option below best describes the institution that your CPA is in agreement with?

Question Title

* 10. Which option below best describes the institution that your CPA is in agreement with?

What types of barriers to implementation did you encounter with your CPA?

Question Title

* 11. What types of barriers to implementation did you encounter with your CPA?

Please check all that apply:

Question Title

* 12. Please check all that apply:

May we contact you if we have further questions?  If so, please provide your preferred method of contact:

Question Title

* 13. May we contact you if we have further questions?  If so, please provide your preferred method of contact:

T