ONLY PRACTICE OWNERS to reply, one per business unit

Please Note:
All information/data provided will be made available for HealthMan only.
Only the consolidated results with no reference to any practitioner will be made available to ADSA.

Click the appropriate answer:  only one answer per question is allowed.

GENERAL INFORMATION

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* 1. Name of Practice:

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* 2. Type of Practice:  Legal Entity

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* 3. In which province is your practice located?

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* 4. Practice Location:  Where is your practice based?

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* 5. Is your practice mainly located in a:

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* 6. What is the most advanced post graduate dietetics qualification that you have?

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* 7. What is generally your preferred method of communication with Schemes?

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* 8. What area do you have a special interest in?  Select only the main one.

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* 9. How many years have you been practicing?

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