Skip to content
Cardio Oncology Survey
1.
How would you rate your knowledge of Cardio Oncology, cancer and heart disease
Very Knowledgeable
Above Average
About Average
Below Average
No knowledge of cardio oncology
Very Knowledgeable
Above Average
About Average
Below Average
No knowledge of cardio oncology
2.
How comfortable are you treating patients with cancer therapy related cardiac toxicities?
Uncomfortable
Somewhat uncomfortable
Neither comfortable nor uncomfortable
Somewhat comfortable
Comfortable
Uncomfortable
Somewhat uncomfortable
Neither comfortable nor uncomfortable
Somewhat comfortable
Comfortable
3.
Do you take care of cardio oncology patients in your practice?
Yes
No
4.
If yes:
<10 % of my practice
<30 % of my practice
<50% of my practice
> 50 % of my practice
5.
Are there dedicated cardio oncology services in your hospital/community?
Yes
No
I don't know
6.
If yes, have you referred any patients to those services?
Yes
No
7.
What level of cooperation do you have with your local oncologists for co-management of cardiovascular complications of cancer treatment? (1-5)
No cooperation
Low cooperation
No opinion
Some cooperation
Excellent Cooperation
No cooperation
Low cooperation
No opinion
Some cooperation
Excellent Cooperation
8.
Are there local cardio oncology educational resources in your community? Check all that apply.
Conferences
Tumor boards
Case presentation meetings
Other (please specify)
9.
Do you find having cardio oncology services/practice in your community of value?
Yes
No
10.
What are the main barriers in establishing a cardio oncology program/practice in your community? Check all that apply.
Lack of awareness
Lack of mentoring
Lack of interest
Lack of financial resources
Inadequate reimbursement
Not considered important
Political/employer referral bias
11.
How many educational programs in Cardio Oncology have you attended in the last 3-5 years?
12.
Which programs (if any) did you attend? Check all that apply.
Global Cardio Oncology Summit
ACC Cardio Oncology
Memorial Sloan Kettering
ACC or AHA Scientific Meeting cardio oncology session
Other (please specify)
13.
Is there anything important that would concern cardio oncology in your community that we have not addressed?
The following information will be used for demographic purposes only.
14.
What is your age?
30-39
40-49
50-59
60 or older
15.
What is your gender?
Female
Male
Other (specify)
16.
Type of Practice
Private
Academic
Hospital employed
Single practitioner
Specialty group
