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First Name
Last Name
Are you a licensed health/mental health provider or trainee?
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Licensed provider
Trainee
Other
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How many post-graduate years have you been working?
How many years has it been since you completed your undergraduate degree?
What is your highest education level?
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Associates degree
Bachelor's degree
Master's degree
Doctorate degree
Other
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What is your primary field?
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Psychology
Social Work
Counseling
Nursing, Medicine (MD/DO/PA)
Other
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What is your setting (select all that apply)
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What percentage of your current assignment is spent in clinical work?
What percentage of your clinical time to do you spend delivering cognitive behavioral therapy?
What percentage of your clinical time is spent assessing and/or treating sleep disorders?
Approximately what percentage of your patient population is active duty?
Approximately what percentage of your patient population is veteran?
Tell us about any exposure you have had to CBTI (e.g., 1 hour lecture, read articles, included in course content, etc.)
In what region do you live and practice?
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New England (Maine, Rhode Island, Vermont, Connecticut, New Hampshire, Massachusetts)
Mid-Atlantic (New York, New Jersey, Pennsylvania)
Southern (Virginia, West Virginia, Kentucky, Delaware, Maryland, North and South Carolina, Tennessee, Arkansas, Louisiana, Florida, Georgia, Alabama, Mississippi)
Mid-West (Michigan, North and South Dakota, Iowa, Minnesota, Kansas, Nebraska, Ohio, Indiana, Illinois, Wisconsin, Missouri)
South-West (Texas, Arizona, New Mexico, Oklahoma)
Rocky Mountains (Montana, Idaho, Colorado, Utah, Wyoming, Nevada)
Pacific Coastal (California, Oregon, Washington)
Alaska or Hawaii
Outside the US
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