Pre-Elective Survey 2014

Please complete the following survey before viewing the BMT curriculum modules. Your responses will be used to assess and improve the program. After viewing the curriculum, you will be asked to complete a second survey. We are asking for your name so we can compare your pre- and post-experience. Your director will not receive your individual responses. Thank you for your time.

Question Title

* Registration:

Name

Question Title

* My training level is:

Third year medical student

Fourth year medical student

Second year resident

Third year resident

Fellow

Physician who performs transplant

Physician who refers patients to transplant

Nurse Practitioner

Physician Assistant

Pharmacist

Other

Question Title

* Are you taking this as part of an elective rotation?

Yes