Epic Accelerated Classroom Training Survey Providers--MD, DPM, DO, PA-C, ARNP, etc.

WELCOME & OVERVIEW

Welcome to Overlake Epic Accelerated Training

This survey is designed to identify new providers who qualify for Epic Accelerated Training (which consists of abbreviated classroom Epic Training).

Below is a list of provider roles for which Accelerated Classroom Training is currently available.

If your role is not listed, it means an Epic Accelerated Classroom Training course is not offered. Therefore, do not complete this survey.  You will be enrolled in the corresponding Epic Course for your role/specialty.

Please read all information/items carefully and provide candid responses to survey items.

Anticipate a response for the status of approval for Epic Accelerated Classroom Training from the Epic Training Team within 3 business days.

  ROLES CURRENTLY PARTICIPATING IN EPIC ACCELERATED CLASSROOM TRAINING
  If your role is not listed, please do not complete this survey.

Ambulatory: Physician/Provider, Physician Assistant (PA), Advanced Registered Nurse Practitioner (ARNP)
Inpatient: Physician/Provider, Surgeon, Advanced Registered Nurse Practitioner (ARNP), Physician Assistant (PA)
Surgical Staff: Surgeon, Physician Assistant (PA)

Question Title

* 1. Contact Information

Name (First MI Last)

Email Address

Phone Number

Question Title

* 2. Employer Information

	YES	NO
Are you an Overlake Employee?	Are you an Overlake Employee? YES	Are you an Overlake Employee? NO
Are you an Overlake Locum?	Are you an Overlake Locum? YES	Are you an Overlake Locum? NO
Are you a non-Overlake Employee?	Are you a non-Overlake Employee? YES	Are you a non-Overlake Employee? NO

If you are a non-Overlake employee, please enter the organization you work for.