Anti-infectives Key Opinion Leader (KOL) Survey
Name
First Name
Last Name
Territory
1. Who are the top 5 Key Opinion Leaders (KOLs) on your territory and why?
Please include their full name and Trust (e.g.: Dr. John Doe - Microbiologist, North Middle University Hospital NHS Trust) and the reason for selecting them as a KOL.
1. Microbiologist
Why?
2. Microbiologist
Why?
3. Microbiologist
Why?
4. Pharmacist
Why?
5. Nurse
Why?
Other:
Please fill out the following table for each of the KOLs listed above in relation to their advocacy status for fidaxomicin
Negative Advocate
Somewhat NegativeAdvocate
Neutral
Somewhat Positive Advocate
Positive Advocate
1.Microbiologist
1
2
3
4
5
2.Microbiologist
6
7
8
9
10
3.Microbiologist
11
12
13
14
15
4.Pharmacist
16
17
18
19
20
5.Nurse
21
22
23
24
25
2. Who do you believe are the top 3 rising stars on your territory and why?
Please include their full name, profession, and Trust (e.g.: Dr. John Doe - Microbiologist, North Middle University Hospital NHS Trust) and the reason for selecting them as a rising star.
1.
Why?
2.
Why?
3.
Why?
Other:
3. From the HCPs listed above, please identify the HCP(s) that would most benefit from greater engagement with the Medical Team and why?
26
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