Health Network / Facility Characteristics

* 1. Please specify your Health Network, Agency, and/or Facility Name:

* 2. Please provide the following for the primary point of contact:

* 3. Please choose applicable care settings:

* 4. How many of each of the following roles are employed or contracted within your organization (full- and part-time)?

* 5. How many facilities or agency offices does your organization support?

* 6. How many patients does each facility or agency office serve, approximately?

* 7. Are your facilities in a metro or rural statistical area?

* 8. In which states are your facilities or agency offices located?

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33% of survey complete.