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1. Are you currently experiencing workplace-related burnout?
(Required.)

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2. Have you experienced workplace-related burnout in the past?
(Required.)

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3. Have you noticed an increase in feelings of burnout among yourself, your colleagues, or your staff over the past three years?
(Required.)

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4. Have you helped a colleague or direct report address burnout?
(Required.)

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5. What do you do to prevent or address burnout? (Required.)

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6. Would you be willing to participate in a one-on-one or group discussion on burnout? (Select all that apply.) (Required.)

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7. To participate in a group or one-on-one discussion, please enter your contact information.

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