Fentanyl Questionnaire for Healthcare Providers
This survey was developed by the Colorado Consortium's Provider Education Work Group. The intent of the survey is to understand how illicit fentanyl is presenting in healthcare settings around Colorado. This survey should take no more than 5 minutes of your time. Thank you for your help!
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What is your degree?
What is you practice specialty?
What is your practice setting?
How would you describe your practice location?
How many years have you been in practice?
Clear selection
Does the urine toxicology test you use in your practice test for fentanyl?
Are you waivered to prescribe buprenorphine? If no, skip to question 9
Clear selection
If so, do you actively prescribe to any clients?
Clear selection
Have you seen an increase in patients reporting fentanyl (or street oxycodone) use?
Clear selection
If so, has this resulted in any changes to your practice?
Do you think you or any provider colleagues would benefit from increased information about illicit fentanyl?
Clear selection
If you answered some other change to your practice after seeing an increase in fentanyl in question 10, please comment below:
Please write below any additional topics related to fentanyl that you would like to learn more about:
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