Tactic Team Questionnaire

FMAH smaller2

Introduction

Family Medicine for America’s Health (FMAHealth) seeks to ensure family medicine will meet the needs of the American public by achieving the Triple Aim of better care, better health, and lower cost.

The FMAHealth initiative brings together a diverse set of stakeholders, including each of the eight sponsoring family medicine organizations, patients and patient advocates, practicing physicians, students, residents and teachers, and other primary care professionals.

This questionnaire is your start at playing a very important role in the strategy implementation of FMAHealth. You'll learn more about the overall effort, and then we’ll ask you to let us know how you'd like to get involved. First, we'd like to learn a little more about you.

We expect this questionnaire will take about 15 minutes to complete. Please be sure to press "Finish Survey" at the end or your responses won't be recorded. If you'd like to navigate back at any time, please press the back button on your browser.

Q.1


Q.2
Please list your credentials here (for example, MD, DO, RN, MPH, etc.)

Q.3
What is your preferred email address?

Q.4
What is your preferred mailing address?





Q.5
Is this address for your home, work, or other?

Q.6
What is your preferred phone number?

Q.7
Is this phone number for your home, cell, work, or other?

Q.8
How did you hear about FMAHealth?