MIPS: Quality Payment Reform Wednesday, January 24, 2018 (8:30 am - 12:30 pm) -- BHCC 112/114 Contact Information Question Title * Name Question Title * Title Question Title * Employer Question Title * Primary Phone Question Title * Primary Email Question Title * Street Address Question Title * City / State / Zipcode UCA would like to collect demographic information to help us better serve our customers and event participants. These questions are voluntary and any information you provide will remain confidential and will only be used in aggregate form. Question Title * What is your gender? Male Female Prefer Not To Answer Question Title * Please select the category that includes your age: 17 or younger 18-24 25-34 35-44 45-54 55-64 65 or older Question Title * Which of the following best describes you? American Indian/Alaska Native Asian Black/African American Hispanic/Latino Native Hawaiian/Pacific Islander White/Caucasian Two or More Races Question Title * What is the highest level of education you have completed? Some high school High school or equivalent (GED) Some college Trade/technical/vocational certificate Associate degree Bachelor's degree Master's degree Professional degree Doctorate degree DONE
