Physician Group - Moving Forward Together - (copy)
Name: 


A red asterisk (*) indicates required questions.

  1. What are your current responsibilities in your program?*


  1. What would be your ideal job/responsibilities?*


  1. What aspects/parts of your job do you like the most?*


  1. What aspects/parts of your job do you like the least?*


  1. What is the most frustrating part of your job?*


  1. Do you favor making home visits?*
     
      1 2 3 4 5  
    1-Very little  5-Favorite


  1. Do you favor running hospice teams?*
     
      1 2 3 4 5  
    1-Very little  5-Favorite


  1. Do you favor rounding in the IPU?*
     
      1 2 3 4 5  
    1-Very little  5-Favorite


  1. Do you favor inpatient palliative care?*
     
      1 2 3 4 5  
    1-Very little  5-Favorite


  1. What makes you excited about the merger?*


  1. What makes you anxious about the merger?*


  1. Suggestions:


  1. 'Best available times' to meet:*





Abbe Leffel
IL