TREAT ME Initial Interest Survey Question Title * 1. Please provide your credentials (MD, DO, PA, NP, PhD, RN, other) Question Title * 2. Are you planning to attend the entire collaborative or one or more individual blocks? Entire collaborative One or more individual blocks Question Title * 3. Are you enrolling as a member of a practice team? Yes No Question Title * 4. Please Name Team Lead: Question Title * 5. Practice Scope: Psychiatry Pediatrics Behavioral Health Family Medicine Addiction Medicine APP Other: Question Title * 6. Do you use a validated tool such as BSTAD, S2BI, or CRAFFT to screen for adolescent substance use in your practice? Yes No Question Title * 7. Do you or does anyone in your practice provide buprenorphine to adolescents to treat OUD? Yes No Question Title * 8. Do you offer medication for nicotine use disorder to adolescents? Yes No Question Title * 9. Do you offer medication to treat alcohol use disorder for adolescents? Yes No Question Title * 10. Do you have embedded behavioral health in your practice? Yes No Done
