AAPA Employee Recognition Program Survey

Thank you for taking time to recognize our Associated Anesthesiologists, P.A. (AAPA) employees!

[Note: This is a secure, HIPAA-compliant survey system.]

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* 1. Your Name:

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* 2. Where did you have your procedure? Please choose the location from the dropdown menu.

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* 3. What was the date of your procedure?

Please enter a date:

Date

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* 4. I would like to recognize my:

Anesthesiologist (physician)

Nurse anesthetist (CRNA)

Other

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* 5. Do you know the name(s) of the AAPA employees that you would like to recognize?

Yes

No