Telemedicine Training Interest Survey
Let us know your interest and preferences for upcoming telemedicine training opportunities.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Professional Role
*
Please Select
Physician
Nurse
Allied Health Professional
Administrator
Student
Other
How familiar are you with telemedicine practices?
*
Not familiar
1
2
3
4
Very familiar
5
1 is Not familiar, 5 is Very familiar
Have you participated in telemedicine before?
*
Yes
No
Which telemedicine topics are you most interested in? (Select up to 3)
*
Clinical Best Practices
Technology & Platforms
Patient Communication
Legal & Regulatory Issues
Billing & Reimbursement
Workflow Integration
Other
Preferred training format
*
Live Online Workshop
Self-Paced Online Course
In-Person Training
Blended (Online & In-Person)
How would you rate your overall interest in telemedicine training?
*
1
2
3
4
5
Please indicate your availability for training sessions.
*
Rows
Morning
Afternoon
Evening
Weekdays
1
2
3
Weekends
4
5
6
Any comments or specific needs?
Submit
Should be Empty: