Pain Management Practice Survey: Your feedback is appreciated!

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* 1. What is your name?

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* 2. What is your professional title or position?

Other (please specify)

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* 3. How many physicians are in your location?

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* 4. Is your practice a(n):

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* 5. Does your practice offer (Please check all that apply):

Behavioral/Occupational/Physical

Botox

Epidurals | Nerve/Spine Blocks

Diagnostic Imaging Services

Drugs of Abuse Monitoring

IET

In-house lab services

In-house pharmacy services

Joint and Ligament Injections

Massage Therapy

Medication Management

PRP

Psychotherapy

RF Nerve Ablation

Other (please specify)

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* 6. In the next six months, will you be considering (Please check all that apply):

Adding a new associate or provider

Adding a new service line, procedure, or therapy

Opening a new or adding an additional location

Adding lab or imaging services

Purchasing capital equipment

Please specify:

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* 7. What is the biggest pain point on the horizon for this practice? (Please check your top 3 concerns):

MIPS/MACRA

Reimbursement changes

Drug diversion

Maintenance of Certification

New regulations or policy

Patient referrals

Practice profitability

Liability

Other (please specify):

Question Title

* 1. What is your name?

Question Title

* 2. What is your professional title or position?

Question Title

* 3. How many physicians are in your location?

Question Title

* 4. Is your practice a(n):

Question Title

* 5. Does your practice offer (Please check all that apply):

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* 6. In the next six months, will you be considering (Please check all that apply):

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* 7. What is the biggest pain point on the horizon for this practice? (Please check your top 3 concerns):

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* 8. Is there anything else you would like to bring to our attention regarding your service experience from Henry Schein?