PQI Level 1 Completion Form for Physicians Question Title * 1. First Name Question Title * 2. Last Name Question Title * 3. MSP # Question Title * 4. Email Address Question Title * 5. Member Type Family Physician Specialist Physician Question Title * 6. Do you identify as a physician primarily working in the community?You spend the majority of clinical time providing patient care from a private (non-facility/HA) office and may, or may not, rely on hospital/Health Authority to provide aspects of patient care. Yes No Question Title * 7. Primary Practice Region (Health Authority or Community) Fraser Health region Interior Health region Island Health region Northern Health region Provincial Health Services Vancouver Coastal Health/Providence Health Care region Question Title * 8. Please confirm the following: I have completed PQI Level 1 courses (IHI Open School QI 101, QI 102, QI 103 + Dr Don Berwick's presentation). Next