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PCRS is asking members and supporters to complete the following survey to help PCRS understand your current practice environment in the context of the ongoing global pandemic. The results of the survey will be shared on a periodic basis on the PCRS website.

Thank you in advance for your time!

Submissions are anonymous unless you choose to provide your name and contact information below.

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* 1. Are you a member of PCRS?

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* 2. Please list your credentials.

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* 3. Primary location Type

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* 4. Primary Practice Setting

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* 5. Primary Practice (where you spend > 50% or more of your time at work)

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* 6. What is the current environment of your office/practice?

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* 7. If you are currently closed, do you anticipate being back open full time in the next 30 days?

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* 8. On a scale of 1-5, how has your employer handled the COVID-19 crisis?
1 - Very Poor
5 - Very Good

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* 9. Do you feel you have adequate PPE to perform your work safely and comfortably?

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* 10. On a scale of 1-5, please describe your level of concern regarding the risk of transmission of COVID-19 to patients, your office team, yourself, and someone at home. 
 1 – Not at all concerned
5 – Extremely concerned

  1 – Not at all concerned 2 – Slightly concerned 3 – Somewhat concerned 4 – Moderately concerned 5 – Extremely concerned N/A
Patients
Office Team
Yourself
Someone at Home

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* 11. PCRS is wanting to support you. Would you be interested in either of the following options?

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* 12. Is there anything else PCRS can do to support you at this time? Is there anything else you'd like us to know? 

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* 13. Optional: You may provide your name and contact information here so PCRS can reach out to you if desired.

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