* 1. Unique Identifier:
Please pick a six-digit passcode. You will use this same passcode for the post-test.

* 2. Demographics:

Gender

* 3. Demographics:

Age

* 4. Demographics:

Provider Type

* 5. Demographics:

Years in Practice

* 6. I need to learn more about colon cancer screening.

* 7. I feel comfortable discussing colon cancer screening with my patients.

* 8. I have time to discuss colon cancer screening with my patients.

* 9. I am knowledgeable about the recommended guidelines on colon cancer screening.

* 10. I believe that a digital rectal exam with stool hemoccult done in the office is helpful in colon cancer screening.

* 11. I believe that annual stool FIT test is helpful in colon cancer screening.

* 12. I believe that a colonoscopy every 10 years is helpful in colon cancer screening.

* 13. A stool FIT will find up to what percentage of colon cancers?

* 14. What percentage of patients that you recommend for colon cancer screening colonoscopies agrees to be referred for the colonoscopy?

* 15. When recommending colon cancer screening, I currently discuss multiple options with my patients.

* 16. Which colon cancer screening options do you discuss with your patients? CHECK ALL THAT APPLY.

* 17. When referring patients for colon cancer screenings, what percentage of the time do you currently recommend each of the following tests?

Annual Rectal Exam with office stool hemoccults

* 18. When referring patients for colon cancer screenings, what percentage of the time do you currently recommend each of the following tests?

Annual Stool Guaiac Test x 3 for hemoccult

* 19. When referring patients for colon cancer screenings, what percentage of the time do you currently recommend each of the following tests?

Annual Stool FIT test

* 20. When referring patients for colon cancer screenings, what percentage of the time do you currently recommend each of the following tests?

Colonoscopy every 10 years

* 21. When referring patients for colon cancer screenings, what percentage of the time do you currently recommend each of the following tests?

Flexible Sigmoidoscopy every 3 – 5 years

* 22. When referring patients for colon cancer screenings, what percentage of the time do you currently recommend each of the following tests?

Air Contrast Barium Enema

* 23. When referring patients for colon cancer screenings, what percentage of the time do you currently recommend each of the following tests?

Virtual Colonoscopy

* 24. When referring patients for colon cancer screenings, what percentage of the time do you currently recommend each of the following tests?

Stool DNA periodically

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