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. 2011 Jan;25(1):13–20. doi: 10.1155/2011/320904

TABLE 1.

Participant demographic data (entered only once for each participant)

  1. Please enter your ID number

  2. Primary (>50% of your practice) specialty/subspecialty

    • □ Gastroenterology

    • □ Surgery

    • □ Other

  3. Office details – You practice in a:

    • □ University full-time practice

    • □ University part-time, private practice part-time

    • □ Private clinic practice

  4. Is this an independent or group practice?

    • □ Independent

    • □ Group

  5. Endoscopy/colonoscopy suite details (check all that apply):

    • □ Community hospital

    • □ University/teaching hospital

    • □ Private clinic

  6. Gender

    • □ Male

    • □ Female

  7. Years in specialist practice

    • □ Less than 2

    • □ 2–5

    • □ 6–10

    • □ 11–20

    • □ 21–30

    • □ More than 30

    • □ N/A

N/A Not applicable