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Name
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First Name
Last Name
Email
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example@example.com
What best describes your title?
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MD/DO
RN/NP
PA
PharmD/RPh
Respiratory Therapist
Non-Clinician Research Coordinator
Other
If MD/DO
cardiologist (interventional)
cardiologist (heart failure)
cardiologist (lipid/vascular)
cardiologist (electrophysiology)
cardiologist (general)
endocrinologist
nephrologist
emergency medicine specialist
neurologist
stroke neurologist
critical care specialist
pulmonologist
primary care provider
industry
Other
If RN/NP
NPP
ICU
cath lab
ward
clinic
academic
industry
Other
If PharmD
hospital/health system-based
community
academic
industry
Other
If PharmD, DOB
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Month
-
Day
Year
Date
If PharmD, NABP ID#
Where are you based?
EU/GB
Canada
USA
Latin America
Australia/NZ
Asia
How did you FIRST hear about our tweetorials?
found it on Twitter searching in subject area
found it on twitter searching for CE/CME
found it on Twitter by following individual influencer
found it on Twitter by following institutional influencer
from LinkedIn
How many years have you been in practice?
How many patients per month do you typically see with the disease addressed in this tweetorial?
1. For which CAT group is bleeding risk on anticoagulation particularly increased?
*
a. leukemia
b. lung cancer
c. GI cancer
d. pancreatic cancer
2. Did you follow the entire tweetorial?
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Yes
No
3. Did you find this to be an effective learning tool?
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Yes
No
4. On a scale of 1 to 5, how applicable to your clinical practice was the material in this tweetorial?
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Not At All Pertinent
1
2
3
4
Extremely Pertinent
5
1 is Not At All Pertinent, 5 is Extremely Pertinent
5. How will this program change your practice?
*
Not pertinent to my practice
Reinforces my practice
Makes me want additional education
Will change my practice
6. Will you recommend @cardiomet_CE and/or this website to your colleagues?
*
Yes
No
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Month
-
Day
Year
Date
Course Title
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