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Cardio-Oncology Survey for ACC State and International Chapters and ICOS Chapters
Demographics
This information is being collected for statistical reasons only and will not be linked to your answers.
1.
What is your age?
18-24
25-34
35-44
45-54
55-64
65+
2.
To which gender do you most identify?
Female
Male
Non-binary
Prefer not to say
3.
What is your specialty?
Cardiology
Oncology
Internal Medicine
Other
4.
Type of Practice - check all that apply
Solo
Group Practice
Private
Academic
Hospital Based
Trainee/Resident/Fellow
Urban/Suburban
Rural
5.
In what country do you work?
Afghanistan
Albania
Algeria
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia (Plurinational State of)
Bosnia and Herzegovina
Botswana
Brazil
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo
Costa Rica
Côte D'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Democratic People's Republic of Korea
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Fiji
Finland
France
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea Bissau
Guyana
Haiti
Holy See
Honduras
Hungary
Iceland
India
Indonesia
Iran (Islamic Republic of)
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People’s Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia (Federated States of)
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Republic of Korea
Republic of Moldova
Romania
Russian Federation
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Sudan
Spain
Sri Lanka
State of Palestine
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syrian Arab Republic
Tajikistan
Thailand
The former Yugoslav Republic of Macedonia
Timor-Leste
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom of Great Britain and Northern Ireland
United Republic of Tanzania
United States of America
Uruguay
Uzbekistan
Vanuatu
Venezuela (Bolivarian Republic of)
Vietnam
Yemen
Zambia
Zimbabwe
6.
If from the United States, in what state or U.S. territory do you currently work?
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia (DC)
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Marianas Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Virgin Islands
Washington
West Virginia
Wisconsin
Wyoming
7.
Please enter the date you are completing this survey.
Date / Time
Date
January
February
March
April
May
June
July
August
September
October
November
December
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
Su
Sunday
Mo
Monday
Tu
Tuesday
We
Wednesday
Th
Thursday
Fr
Friday
Sa
Saturday
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
8.
How has COVID-19 impacted your practice? Select all that apply.
Rescheduling outpatient appointments
Cancellation of most elective procedures
Developed protocols to address patients' anxieties and fears
Decreased use of echo/CT/PET/MR or other imaging modalities
Oncology treatment modified/shortened to balance risk of exposure to COVID-19
9.
Does your institution provide proper protection for all health care workers to the level they are exposed?
Yes
No
10.
Have timely surgery/chemo/immunotherapy treatments for your patients been delayed since the COVID-19 pandemic started?
Yes
No
11.
Do you use telemedicine to reduce in-person encounters and health care providers' exposure?
Yes
No
12.
Have you been asked to reduce your specialized practice to help/contribute to other areas where urgent help is needed?
Yes
No
13.
Have you had in service instruction/guidelines from leadership at your institution about policies to protect your patients, your team, your colleagues and yourself?
Yes
No
14.
Do you feel you have adequate support from your institution's leadership to carry on with your duties?
Yes
No
15.
Do you discuss with all your patients the importance of strict adherence to COVID-19 community behavior as part of your office/clinic encounters?
Yes
No
16.
Do you have access to COVID-19 testing at your institution or local lab?
Yes
No
17.
Has your institution used empiric treatment with Remdesivir or other anti-viral treatments for the sickest patients?
Yes
No
18.
Has your institution used Tocilizumab or other anti-inflammatory agents for COVID-19 related myocarditis?
Yes
No
19.
In your opinion, should there be a government mandated nationwide quarantine/lock-down to slow down the propagation/transmission of COVID-19?
Yes
No
20.
Should medical professional organizations take a more active role, and have more influence in official health care policy decisions during this major crisis?
Yes
No