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Medical Degree
What best describes your medical degree?
Verification of Medical Licensure
US physicians, enter your DEA number or, if not available, your medical license number and state of licensure; foreign physicians, enter your license number or equivalent. (For verification only)
Primary Medical Specialty
Board Certified
Are you board certified in your primary medical speciality?
Secondary Medical Specialty
Board Certified
Are you board certified in your secondary medical speciality?
Practice Type
Practice Setting
In what type of area is your practice located?
Patient Encounters Per Week
How many unique patient encounters do you have or oversee in a typical week when engaged in patient care?
Weeks of Clinical Practice Per Year
How many weeks per year are you engaged in patient care in this manner?
Prescriptions Per Week
How many prescriptions do you typically write or oversee in a week?
Academic Appointment
Are you engaged in direct supervision of residents or fellows for at least 5 percent of your professional work time?
Expert Witness Experience
Have you recently served as a consultant to lawyers or as an expert witness/reviewer on at least 2 cases per year?
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