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* 1. Email address (optional, only need if you would like to be entered to win $50 a giftcard) Winner will be notified in early June. 

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* 2. What is your practice type?
Please select all that apply

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* 3. What is your practice location?

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* 4. How large is your practice organization?

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* 5. What program(s) does your practice participate in?
Please select all that apply.

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* 6. How well would you rate your understanding of your payer contracts?

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* 7. If you are in an independent practice, how would you rate your level of comfort with negotiating with payers?

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* 8. If NOT in an independent practice, would you like to have more information from your overarching organization about your payer contracts?

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* 9. How would you prefer to receive business support?
Please select all that apply.

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* 10. If you selected direct one-on-one coaching at the practice, please indicate if you would be willing to pay for this service.

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* 11. If you selected virtual/webinars or office hours, please specify what times would be best?

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* 12. If you selected virtual/webinars or office hours do you prefer.

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* 13. Who in the practice would you suggest participate?

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* 14. What business support topics would you like to see covered? 
Please select up to 5 items as priority 1, if you have others you are interested in, select up to 5 as priority 2. 

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* 15. If you selected coding as a topic, please indicate for which payers.

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* 16. Please provide any additional comments regarding business support you would like to see.

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* 17. If you have participated in SIM or TCPi business support offerings, which were most beneficial to you?

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