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* 1. Contact information

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* 2. Have you taken part in an online survey about local cancer care hospitals in recent months?

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* 3. What is your gender?

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* 4. Please indicate your age.

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* 5. Do you or does anyone else in your household, work for one of the following types of companies, organizations or departments? 

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* 6. What is your area of specialization?

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* 7. We are looking to talk to people in different areas. In how many different locations do you practice?

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* 8. Please enter the zip code for each practice. And the next, and the next…

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* 9. How often have you had occasion to refer patients for cancer investigation or treatment in the last 12 months? Please record the number of times.

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