Site
1. Site and department name
2. Type of practice or institution: University Hospital, Community Hospital, Group
Practice, Private Practice, Stand-alone Research Center, Other: ____________
3. How many active patients does your [site/department] have (visits within past 12
months)?
4. How many physicians at your site treat patients with the willies?
5. How many clinical research studies are currently active at your [site/department]?
6. How many physicians at your [site/department] are currently principal investigators on
clinical research studies?