1.What is your healthcare job position 

Physician

Nurse 

Prehospital 

Social worker 

Other Provider 

2.How familiar are you with the SBIRT Process ?

Extremely familiar

Very familiar

Somewhat familiar

Not so familiar

Not at all familiar

3.How familiar are you with the AUDIT C Screening process ?

Extremely familiar

Very familiar

Somewhat familiar

Not so familiar

Not at all familiar

4.An AUDIT -C screening of >____ is considered positive

5

8

10

I have no idea 

5.How familiar are you with the DAST-10  Screening?

Extremely familiar

Very familiar

Somewhat familiar

Not so familiar

Not at all familiar

6.A DAST-10 Score of greater than>____ indicated the need for further investigation for SUD?

1

8

3

6

I have no idea

7.How familiar are you with COWS assessments?

Extremely familiar

Very familiar

Somewhat familiar

Not so familiar

Not at all familiar

8.How familiar are you with SOWS assessments

Extremely familiar

Very familiar

Somewhat familiar

Not so familiar

Not at all familiar

9.How familiar are you with CIWA assessments 

Extremely familiar

Very familiar

Somewhat familiar

Not so familiar

Not at all familiar

10.I am comfortable discussing substance abuse with my patients? 

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

11.I am knowledgeable about medication assisted treatment for substance abuse. 

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

12.I find it simple to find treatment and follow up options for patients with substance abuse disorders.

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree