* 1. Please provide your sex/gender:

* 2. What is your profession?

* 3. What are your roles within the practice (select all that apply)?

* 4. Which of the following best describes your employment practice model?

* 5. How many years have you been in practice?

* 6. How many years have you been in bariatrics?

* 7. What is your employment status?

* 8. What percent of your time is dedicated to bariatrics?

* 9. Of your time dedicated to bariatrics, what is the percentage for:

  10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 0%
Clinical
Administrative
Data Collection/Research

* 10. What is the amount of your total compensation, including salary, bonus and/or incentive payments, research stipends, honoraria and medical directorship fees in 2016? (state the amount reported as direct compensation on Form W-2 and Form 1099; US dollars)

* 11. Which of the following benefits are provided to you and paid by your employer?

* 12.  How many total clinic (office) visits did you have in 2016?

* 13. Do you take call?

* 14. If yes,  how often?

* 15. Are you compensated for taking call?

* 16. If yes, how much are you paid per call?

* 17. Does your contract contain an incentive or productivity bonus?

* 18. If yes, please describe incentive or productivity bonus:

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