PART 1

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* 1. What is your primary area of practice?

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* 2. Please provide the zip code for where you practice:

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* 3. Number of veterinarians in your practice: (Please count each full-time vet as “1,” halftime vets as “0.5,” such that a practice with 2 full time and 3 part/halftime vets would have 3.5 doctors.)

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* 4. How many of the veterinarians in your practice hold a valid DEA License?

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* 5. How often do you perform a controlled substance inventory count/reconciliation?

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* 6. Have you had any discrepancies in your inventory of controlled substances? If YES which drugs/form (i.e. pill, injectable…)

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* 7. If yes, which drugs/form?

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* 8. What inventory control measures have you implemented for controlled substances in your practice? (For example: Do you drug test employees? Perform background checks prior to hiring? Use surveillance cameras?)

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* 9. Are you and other licensed veterinarians in your practice the only ones that have access to your controlled substance inventory?

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* 10. How many cases have you had in approximately the last 5 years where you suspect the client has intentionally harmed their animal to obtain controlled substances? If so, how many/often?

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* 11. How many cases have you had in the approximately the last 5 years where you suspect the client is misusing their animal’s prescription for a controlled substance for themselves or diverting the medication? If so, how many/often? (These types of suspicious behavior include an owner bringing in multiple pets for a very specific yet uncommon problem, requesting specific medications by trade or generic name, requesting multiple refills without recheck, claiming a particular illness without the presences of any clinical signs on an exam or even repetitive “vet shopping.”)

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