2018 CAPNI Practice Survey

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* 1. Please indicate the type of APRN.

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* 2. Which organization (s) are you a member of?

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* 3. Please indicate your educational level.

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* 4. Are you certified?

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* 5. What type of certification do you have?

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* 6. What type of practice are you working in or if you are retired, what was your last area of practice?

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* 7. How would you designate your geographic location of practice?

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* 8. What is your county of residence?

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* 9. What is your county of practice?

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* 10. How many years have you been practicing as an APRN?

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* 11. How many years did you practice as an RN before becoming an APRN?

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* 12. Do you have prescriptive authority to practice in Indiana as an APRN?

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* 13. How many physician collaborators do you have?

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* 14. What type of specialty does your collaborator have?

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* 15. Did you or do you currently have difficulty finding a physician collaborator?

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* 16. Do you or your employer provide financial compensation for collaboration?

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* 17. Do you have any of the following barriers in Indiana due to collaboration?

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* 18. Do you carry malpractice insurance or does your employer provide malpractice coverage?

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