IASP Multidisciplinary Pain Center Development Manual Survey
Tell us how you are using the manual in your work! Information in this survey will be used only by IASP staff to demonstrate impact of the manual unless you choose to be contacted at the end of the survey.
Personal Information
What is your first and last (family) name?
*
First Name
Last Name
Email
*
example@example.com
What country do you live in?
*
Please Select
Afghanistan
Albania
Algeria
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Côte d'Ivoire
Cabo Verde
Cambodia
Cameroon
Canada
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo (Congo-Brazzaville)
Costa Rica
Croatia
Cuba
Cyprus
Czechia (Czech Republic)
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (fmr. "Swaziland")
Ethiopia
Fiji
Finland
France
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Holy See
Honduras
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar (formerly Burma)
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
North Korea
North Macedonia
Norway
Oman
Pakistan
Palau
Palestine State
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Sweden
Switzerland
Syria
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States of America
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Yemen
Zambia
Zimbabwe
What type of organization do you work for (if any)?
*
Please Select
College/University/Academic Institution
Hospital, healthcare system, or other medical practice
Research Organization
Patient Advocacy Group
Nonprofit or Non-Governmental Organization (not related to pain advocacy)
Other
I am retired.
I do not work.
If you selected other, please enter the type of organization you work for in the box below.
What is your occupation?
*
Please Select
Administrator
Basic Researcher
Clinical Researcher
Clinician
Educator
Other
Retired
Trainee/Student
What is your specialty?
*
Please Select
Anesthesiology
Complementary & Alternative Medicine
Dentistry/Oral Medicine
Dermatology
Epidemiology/Public Health
Family Medicine/Primary Care
Gerontology
Healthcare Administration
Internal Medicine
Neuroscience
Nursing
Obstetrics/Gynecology
Oncology
Orthopedics
Occupational Therapy
Pain Medicine
Palliative Medicine
Pediatrics
Pharmacy
Pharmacology
Physical Medicine & Rehabilitation
Physical Therapy
Physiology
Psychiatry
Psychology/Social Science
Research Administration
Rheumatology
Surgery
Veterinary Medicine
Are you an IASP Member?
*
Yes
No
Are you a member of the pain society in your country?
*
Yes
No
Clinic Information
Does your country currently have a multidisciplinary pain center?
*
Yes
No
What is the name of your country's mutlidisciplinary pain center?
If there is more than one in your country, please type as much information as you know.
In what city or region is the multidisciplinary pain center located?
If there is more than one in your country, please type all locations.
Do you see a need to open an additional multidisciplinary pain center?
Yes
No
Do you see a need for a multidisciplinary pain center in your country?
Yes
No
Are you involved in the establishment of a multidisciplinary pain center in your country?
Yes, I am in charge of establishing one.
Yes, I am part of a team establishing one.
No
Additional Resources
Would you like additional resources about multidisciplinary pain centers?
*
Yes
No
What types of resources would you like?
Research Articles
Slide Presentations
Videos
Questionnaires or other tools to use with patients
Virtual training through web conference (such as Zoom)
In-person training
Would you like a member of the Advisory Group to contact you for additional assistance?
*
Yes
No
Can IASP contact you to find our more information about pain management in your country and/or how you are using the manual?
*
Yes
No
Submit
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