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1. Number of years in practice (Required.)

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2. Solo Practice? (Required.)

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3. Type of Practice: (Required.)

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4. Number of providers you share office space with: (Required.)

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5. Do you consider yourself a general otolaryngologist? (Required.)

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6. Are you a subspecialist? (Required.)

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7. Number of clinic days per week: (Required.)

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8. Number of patients seen per week: (Required.)

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9. How many years do you have left in practice? (Required.)

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10. Are you hiring a new physician? (Required.)

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11. Do you believe there is a workforce shortage? (Required.)

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12. Do you take ER call? (Required.)

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13. What is your ER call compensation per shift? (Required.)

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14. How many hospitals do you see patients for? (Required.)

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15. Contact Info: (Required.)

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