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Injection Survey
1.
Are you a nurse practitioner or physician assistant/associate?
Nurse practitioner
Physician assistant/associate
2.
How many years have you been working in movement disorders?
<5 years
5-10 years
11-15 years
>15 years
3.
What state do you practice in?
4.
Do you perform toxin injections in your current practice?
Yes
No
5.
Which toxins do you use for injections?
Botox
Xeomin
Dysport
Daxxify
Myobloc
None of the above
6.
Are you interested in learning to inject toxins such as Xeomin for sialorrhea?
Yes
No
7.
Which indications do you inject for?
Sialorrhea
Blepharospasm
Hemifacial spasm
Oromandibular dystonia
Cervical dystonia
Limb dystonia
Spasticity
Other (please specify)
8.
Which indications are you interested in learning to inject?
Sialorrhea
Blepharospasm
Hemifacial spasm
Oromandibular dystonia
Cervical dystonia
Limb dystonia
Spasticity
Other (please specify)
9.
What is your practice setting?
Academic hospital system
Private practice
10.
What type of practice do you currently work in?
Movement Disorders Center
General Neurology
Other
11.
If you don't currently inject, why not?
I am not interested.
Administration will not allow me to inject.
Billing/Reimbursement is a concern.
It is too much work to obtain privileges.
Other (please specify)