Pediatric Provider Survey

Please help the Massachusetts Act Early State Team and its Early Identification Task Force to better understand autism screening practices in Massachusetts and to conduct a needs assessment in pediatric primary care. Upon completion of this 10 minute research survey, you will receive a valuable autism resource in the form of a 2013 listing entitled "Autism & Developmental Disorders Diagnostic Services" compiled by the MA Act Early State Team.

All information collected from this survey will be kept completely confidential. There will be no connection between your responses and your email address.

Your participation in this survey is voluntary. If you decide to quit at any time before completing all of the questions or if you do not click on the ‘Done’ button at the end, your answers will not be saved or recorded. No risks or discomforts are anticipated from your participation in this survey.

By beginning this survey, you acknowledge that you have read this information and agree to participate. You also understand that your participation in this study is voluntary. Please answer the following questions as honestly as possible.

If you have any questions or concerns, please contact Dr. Roula Choueiri by email (rchoueiri@tuftsmedicalcenter.org) or by phone (617-636-8328).

Please click on the "Next" button below to begin the survey.

Thank you for your participation!

The Massachusetts Act Early State Team - Early Identification Task Force

Massachusetts Act Early aims to educate parents and professionals about healthy childhood development, early warning signs of developmental disorders including autism spectrum disorder, the importance of routine developmental screening, and timely early intervention whenever there is a concern.

For more information, visit: www.MAActEarly.org