1. How did you hear about the Health Care Decisions Web site?

2. With what percent of your patients do you discuss Advance Directives?

 %

3. What percent of your patients have completed Advance Directive on their charts?

 %

4. What is the greatest barrier to discussing Advance Care Planning with your patients?

5. Did you find this Web site helpful?

    Yes
    No

6. After reviewing this Web site, is there anything else you want to know?

7. Tell us about yourself:

Specialty practice: How long in practice:

    Male
    Female

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