NCCC Survey for Future Services

1. Introductions

National HIV/AIDS Clinicians' Consultation Center (NCCC)

NCCC Future Services Survey

We would like to ask you a few questions about your preferences for clinical HIV consultation to help steer the direction of our future services. Thank you for taking the time to help us evolve the way we provide clinical consultation.

Question Title

1. Your responses will be kept strictly confidential.

Your Name (optional):

Your Facility (optional):

Question Title

2. Please describe your profession.

MD/DO

NP/PA/CNM

RN/LVN

Pharmacist

Dental

Other medical

Other non-medical

Other (please specify)

Question Title

3. Please describe your facility.

Hospital

Non-hospital - Occupational/Environmental Health

Non-hospital- Private Practice/HMO

Non-hospital- Urgent Care

Non-hospital- Community Clinic

Non-hospital- Dental

Non-hospital- Other

Other Medical

Other Non-Medical

Other (please specify)

Question Title

4. Which of the NCCC services have you used before?

Warmline

PEPline

Perinatal HIV Hotline

E-mail consultation

NCCC PEPline Online Guidances for Occupational Exposure

Compendium of State HIV Testing Laws

Other

None

Other (please specify)