McFarland & Associates Physicians Interest Survey

Are you interested in a free practice assessment?

If so, please fill out the following form:

*Indicates Mandatory Field

Practice Name*

First Name*

Last Name*

Address*

City*

State/Province*

Zip*

Phone*

Email*

Practice Specialty Select all that apply. Hold down the control key to select more than one option.

Please Specify Other Practice Specialty

Number of Locations

How many years have you been in practice?


Practice Management	Please Specify Other Practice Management System
Electronic Health Records (EHR)	Please Specify Other Electronic Health Records
Revenue Cycle Management	Please Specify Other Revenue Cycle Management System

What are your short term goals for the practice? (Ex: decrease operational costs) Select all that apply. Hold down the control key to select more than one option.	Please Specify Other Short Term Goals
What are your long term goals for the practice? Select all that apply. Hold down the control key to select more than one option.	Please Specify Other Long Term Goals

Workflow Difficulty:

Other Workflow Difficulty

Any fears or concerns with moving to EHR? (Select all that apply. Hold down the control key to select more than one option.)

Other Concerns

Do you have a research interest?