Regional Provider Agency EMS Medical Director Survey

Name *

First

Last

Agency/Organization represented *

How long have you served in your current EMS Medical Director role for this agency? *

What is your employment status for this agency? *

How many hours per month are you contracted or expected to provide for this agency? *

If you receive pay for your position, please choose the range of compensation

What board certifications do you currently hold? *

In addition to your EMS Medical Director role, what is your primary practice setting? *

Please list your current primary place(s) of employment or practice. *

Which of the following are part of your role as EMS Medical Director for this agency? *

If you are involved in education, in what ways do you participate?

If you are involved in QA/QI, how do you participate?

How do you stay current on EMS-related topics? *

If you attend EMS-related conferences, which ones?

What do you see as the most important functions of an EMS Medical Director?

What challenges, if any, do you experience in fulfilling your role?