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Physician Pre-Assessment Questionnaire for Diagnostic Imagining Nuclear Medicine Mobile App

The Physician Pre-Assessment Questionnaire for Diagnostic Imagining Nuclear Medicine mobile app allows physicians to evaluate the skills required for diagnostic imagining used in nuclear medicine. A GoCanvas account can be specified as being HIPAA compliant. By turning on HIPAA compliance, a number of features that most of users find desirable will be disabled to meet HIPAA Standards. Individual apps in the GoCanvas Application Store can easily be made HIPAA Compliant. If you have any questions or need assistance you can contact our Sales team to help you at Sales@GoCanvas.com. If you would like to enable HIPAA on your GoCanvas account please follow the instructions below: 1. Log onto your Account 2. Click “My Account” in the top right corner of the screen 3. Click “Customize” on the left 4. The third option is for HIPAA Compliance, click “Edit” on the right 5. Check the “Enable HIPAA Compliance” box and select “Save”

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Included Features

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Included Fields

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I certify that the information provided on this questionnaire is correct and complete
Signature of Physician
Date
Please ensure that a copy of your curriculum vitae and the written agreement between the owner/op...
Surname (as given on CPSO register):
Given name(s) (as given on CPSO register):
CPSO #
Date of Birth
Sex
Medical Degree from University of:
Year:
Speciality
Facility Name
Address
E-mail address
Office Telephone #
Home Telephone#
Cell Phone #
How often do you visit the facility and how do you document this?
When was the last visit?
Do you have regular contact and interaction with peers?
Have you chosen to focus, subspecialise or restrict your practice?
If yes, please specify
Do you have regular contact and interaction with referring clinicians and specialists?
Do you have regular contact and interaction with the owner/operator/licensee?
Examinations
# of Examinations read or procedures performed
Please indicate the types of examinations that you perform/interpret in a typical work-week at th...
...and More!