Amgen TtT - Taiwan Cascading Pre-Assessment

Global Lipid Management Training: Pre-Assessment

Thank you for completing this brief survey. Your responses are confidential and reported in aggregate.

Items with an asterisk (*) must be completed before proceeding to the next page.

Please enter the date of the training workshop you will be attending.*

Format: mm/dd/yyyy

Please answer question 2 before continuing.

Your answer to question 2 must be a valid date.

Participant Information

1. Profession*

MD
NP
PA
Pharmacist
RN
Tech
Other

Please answer question Profession before continuing.

Please fill in the text box next to the selected choice in question Profession.

2. Specialty*

Adult Cardiology
Pediatric Cardiology
CV Surgery
Family/General Practice
Internal Medicine
Pharmacology
Radiology
Other

Please answer question Specialty before continuing.

Please fill in the text box next to the selected choice in question Specialty.

3. Current Practice Setting* (Select all that apply.)

Public Hospital
Private Hospital
Primary Care Private Practice
Community Health Center
Medical School/University
Other

Please answer question Setting before continuing.

Please fill in the text box next to the selected choice in question Setting.

Please select at least 1 choices for question Setting.

4. Years of Experience in Cardiology*

0 to 5 years
6 to 10 years
11 to 20 years
21 to 30 years
31+ years

Please answer question Yrs_Experience before continuing.

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ACC-Amgen Lipid Training - TaiwanPre