Response-O-Matic Form

 

Resident Spouse Support Survey!

Please rank the program you or currently in. If you have finished residency, please rank the program that you attended!

Please complete the survey and then click on 'Submit' . send.

 

Your name:

Email address:

What is your spouse's training year?

Intern
PGY-2
PGY-3
PGYG-4+
Fellowship
Finished with Training!

 

What is your spouse's area of training? ie..Internal Medicine, Surgery, OB/Gyn, Family Practice...

 

What is the name of the program and the location?

How many hours a week is/was your spouse typically at the hospital?

30-40
41-50
51-60
61-70
71-80
81-90
91-100
100+

Does/Did the hospital have a support group for spouses?

Yes
No
Don't Know

Would you recommend this program to other spouses?

Yes
No
Unsure

 

What are/were the best rotations at this program for you and your spouse?

 

What are/were the worst rotations at this program for you and your spouse?

 

Does/Did the Program provide medical and dental insurance?

Medical
Dental
Both
Neither

 

Briefly describe the surrounding communities ie, shopping, entertainment, schools

 

What additional things would you like other spouses to know about this program? If you would NOT recommend the program to other spouses why not? All comments in this survey are anonymous and no names or identifying information will be posted.

 

 

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Resident Spouse Support!
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