Attachment E -- Oral meds for Type 2 diabetes clinician guide _ feedback survey for health care providers

Form Approved OMB No. 0935-0128 Exp. Date XX/XX/20XX

Thank you for taking the time to tell us what you think about the Comparing Oral Medications for Adults with Type 2 Diabetes clinician summary guide. The information you provide will help us to improve current and future guides. You may choose not to answer any question, and your responses are completely anonymous. No information that could be used to identify you will be collected. The average time required to complete this survey is 5 minutes.

0. Please choose ONE statement that best describes you:
X	I am a health care professional who provides care to people with Type 2 diabetes
	I am a health care administrator or policymaker
	I have Type 2 diabetes
	I am the caregiver, family member or friend of someone with Type 2 diabetes
	Other ---> Please describe yourself
1. How useful to you was the clinical bottom line section?
	Very useful
	Somewhat useful
	Not very useful ---> Why not?
2. How useful to you was the confidence scale?
	Very useful
	Somewhat useful
	Not very useful ---> Why not?
3. How useful was the cost information?
	Very useful
	Somewhat useful
	Not very useful ---> Why not?
4. Did you learn anything new from the guide?
	Yes, a lot
	Yes, some
	No

Public reporting burden for this collection of information is estimated to average 5 minutes per response, the estimated time required to complete the survey. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: AHRQ Reports Clearance Officer Attention: PRA, Paperwork Reduction Project (0935-0128) AHRQ, 540 Gaither Road, Room #5036, Rockville, MD 20850.

5. What was your level of knowledge on this topic before reading the guide?
	Limited
	Fair
	Good
	Very Good
	Expert
6. Did you disagree with any of the information in the guide?
	No
	Yes ---> Please describe
7. Will the information in this guide influence or change your treatment recommendations in the future?
	Yes
	Not sure ---> Why not?
	No ---> Why not?
8. Would this guide help you to discuss treatment options with your patients?
	Yes
	Not sure ---> Why not?
	No ---> Why not?
9. Would you recommend this clinician guide to others?
	Yes, definitely
	Not sure ---> Why not?
	No ---> Why not?
10. Would you like to give us any other comments or thoughts about the guide?
11. How did you find this clinician guide?
	Internet search
	I received an e-mail notification from AHRQ's Effective Health Care Program
	Link from another website ---> Which website?
	Link from companion consumer's guide
	Colleague
	Professional organization email, newsletter, journal ---> Please describe
	Other ---> Please describe
12. Have you seen the companion patient guide, Pills for Type 2 Diabetes: A Guide for Adults, which is available at the Effective Health Care website?
	No
	No, but I plan to look at it
	Yes, I have looked at it
13. What type of health care professional are you?
	Physician
	Physician Assistant
	Nurse Practitioner
	Registered Nurse
	Pharmacist
	Social Worker
	Health Educator
	Dentist
	Medical/nursing/dental/pharmacy student
	Other ---> Please describe
14. Are you:
	Male
	Female
15. What is your age?
	Under 30
	30-44
	45-59
	60 or older