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* 1. Hospital name (optional; providing the hospital name allows our researchers to contact you for clarifying questions)

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* 3. What is the approximate population for where your practice is located?

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* 4. How would you describe the area where your practice is located?

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* 5. Please indicate the type of practice where you currently work. (Choose one.  If your hospital can be described by more than one type of practice, please check the predominant type.)

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