To complete the survey electronically:
- • Download the appropriate physician or hospital partner form. (To the right)
- • Download the form by clicking on the middle icon to the top right of the screen. The file should automatically save to the Downloads folder on your computer.
- • Locate the file in your Downloads folder and open it in Adobe Reader. (If you don't have Adobe Reader program installed, you may download it for free here.)
- • Click and complete the necessary fields, then save the file to your computer.
- • Attach the file in an email to Huifang Chen at firstname.lastname@example.org.
The survey may also be completed manually:
- • Click the appropriate physician or hospital partner form to the right.
- • Print the form by clicking on the print icon to the top right of the screen.
- • Complete the necessary fields, then fax to Huifang Chen at 917-773-8868.
- • If your practice is financially strong, simply check “No,” sign and return.
- • If you have concerns about your practice’s financial sustainability, there are a few additional questions.
- • One questionnaire must be completed for each Practice ID. All information will be secure and confidential.