*1.Participant Information(Required.)

First Name, Last Name

Credentials 

Appointments (Institution) 

Full mailing address 

e mail 

phone number

*2.How many rectal surgeries do you do a year?(Required.)

3.How many laparoscopic rectal cancer surgeries do you do a year?

4.How many TAMIS local excision do you do a year?

*5.What is your comfort level of laparoscopic suturing
(please create a scale from 1-4)(Required.)

1 not comfortable

2 neutral

3 comfortable

4 very comfortable

1 not comfortable

2 neutral

3 comfortable

4 very comfortable

*6.Have you signed up or have taken a formal TME/Tamis?(Required.)

Where

When

Instructor