* 1. Most of the patients with Thrombosis that I see have problems in the following areas, so I would be interested in CPD on these topics:

* 2. List the two diagnoses/clinical problems in Thrombosis that you most frequently encounter:

* 3. What skills or procedures related to Thrombosis would you benefit from learning or reviewing?

* 4. What practice gaps in Thrombosis, if any, have you observed among healthcare providers? (A practice gap is the difference between actual and ideal performance.) Professional practice gaps are measured in terms of:

* 5. What gaps in Thrombosis do you believe are directly affecting your practice? Please check off any or all of the following:

* 6. Which of the following subject areas in Thrombosis would this gap apply to? (Please check off all that apply):

* 7. Where do you go to get information about Thrombosis (website(s), publication, colleague, etc.). Please list all sources.

* 8. Have you ever used the Thrombosis Canada website or App?

* 9. Additional comments

* 10. Name (Optional for discount to conference)

* 11. E-mail address (Optional for discount to conference)

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