Please take a few minutes to complete this brief survey which will help guide us as we organize eHealthConnecticut for the future. Your feedback is important to us in how we can better improve our service.

This survey should only take a few minutes of your time. All respondents will be entered into a drawing for a Google Chromecast.

If you have any questions about the survey, please contact us at info@ehealthconnecticut.org or call 860-240-5617.

eHealthConnecticut Regional Extension Center is funded by the U.S. Department of Health and Human Services, Office of the National Coordinator for Health Information Technology (90RC0053)

* 1. Are you a healthcare provider?

  No I am not MD DO PA NP APRN CNMW DDM
Please select one:

* 2. If you are a healthcare provider, what is your specialty:

* 3. If you are not a healthcare provider, are you a:

* 4. Where do you work?

* 5. Is your practice or organization currently an eHealthCT Regional Extension Center customer?

* 6. If you are a healthcare provider (if not skip to question 8):

  Yes No Don't Know
Are you using an electronic health record (EHR) system?
Have you attested to Stage 1 Meaningful Use?
Is your EHR certified for Stage 2 Meaningful Use?

* 7. If you are using an EHR, what system and version are you using?

* 8. Would you be interested in the following services from eHealthCT? (check all that apply)

* 9. Contact info (optional):

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