COPD Study Doctor Questionnaire
This questionnaire is designed to assess the capabilities of doctors and their practices in conducting clinical research trials focused on Chronic Obstructive Pulmonary Disease (COPD).
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Is the PI specialized in one of the following fields? (Select all that apply
Allergy and Immunology
Pulmonology
Other (please specify)
How many COPD patients does the doctor see each month?
<50
50-100
100-150
> 150
Does your site have experience with COPD trials?
*
Yes
No
When did you finish your most recent COPD study?
-
Month
-
Day
Year
Date
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