1. Human Resources

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* 1. Facility Name:

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* 2. Please indicate the number of non-radiology physicians you have in your facility in each specialty shown below.

  None 1-4 5-10 >10
Anesthesiology
Allergy & Immunology
Breast surgery
Cardiology
Cardiothorac Surgery
Dermatology
Emergency Medicine
Endocrinology
Gastroenterology
General Internal Medicine
General Surgery
Gynecology (non-obstetrical)
Hematology
Infectious Diseases
Intensive Care/ICU
Mastology
Maxillofacial surgery
Neonatology/NICU
Nephrology
Neurology
Neurological Surgery
Obstetrics
Oncology, Medical
Oncology, Surgical
Ophthalmology
Orthopedic Surgery
Otorhinolaryngology (ENT)
Pathology
Pediatrics
Physical Medicine & Rehabilitation
Plastic Surgery
Podiatric Medicine
Psychiatry
Pulmonology
Urology
Radiation therapy
Rheumatology
Vascular Surgery

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* 3. Please indicate the number of radiology personnel you have in your facility in each category shown below

  None 1-4 5-10 >10
Radiologists (all)
Specialty/Fellowship trained radiologists (please list in comments section)
Technicians/Technologists
Medical Physicists

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* 4. Please indicate the number of non-physician staff you have in your facility in each category shown below.

  None 1-4 5-10 >10
Nurses
Midwives
Health Extension Worker, Medical Assistant, or other ancillary clinical personnel
Pharmacists/pharmacy technicians
Information technology personnel, Computer technicians
Non-radiology Lab Technicians
Administrators, bookkeepers, accountants, and other managerial or business staff

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* 5. What types of personnel work at your facility? Select all that apply.

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* 6. Is your facility currently under-staffed in any of the above positions? If so, select "Yes" and please describe below in "Comments".

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* 7. Does you facility have high employee turnover in any of the above positions? If so, select "Yes" and please describe below in "Comments".

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* 8. Comments?

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