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* 1. To the best of your knowledge/awareness:

  None 1 - 2 3 - 5 6 - 10 10+ Don't know
In the last 3 months, approximately how many different allied health professions (not different professionals) have you referred patients to?
Approximately how many different allied health professions are you aware of which are regulated through the Health Practitioners Competence Assurance Act 2003?
How many different allied health professions (not different professionals) make up your multidisciplinary General Practice team?
How many allied health professionals work as part of your General Practice team (either part-time or full-time)?

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* 2. How do you make referrals to allied health professionals? (tick any that apply)

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* 3. If you could make direct electronic referrals from your practice management system, do you think you would refer more patients?

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* 4. Would you/do you ever avoid making a referral to an allied health professional because they may not be regulated under the Health Practitioners Competence Assurance (HPCA) Act?

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* 5. Would you/do you ever avoid making a referral to an allied health professional because you have concerns about the credibility of their training/qualifications?

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* 6. What prevents you currently referring patients to an allied health profession as part of the patients care plan or for support in managing their long-term condition? (tick any/all that apply)

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* 7. If funding were available, which 2 allied health professions would you most likely utilise / have on your team?

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* 8. To enter the draw to win a $50 Whitcoulls Gift Card please enter your name and contact telephone number here (your answers will still be kept anonymous)

Thank you for your responses. More information regarding allied health is available at www.alliedhealth.org.nz

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