Stanford School of Medicine
PCAP– Primary Care Associate Program

PA/FNP Practice Update - Graduate Survey

The graduate survey allows for us to stay in touch with you and to keep track of information that helps our program receive the funding that we need to continue to give an outstanding education for our students. You have the following options for answering the graduate survey:

  1. Complete the post card sent to you with our annual newsletter or as a follow-up to our newsletter (we send three post cards total, one month a part)

  2. Request that we send you a post card:

    Graduate Survey Post Card Request
    Primary Care Associate Program
    Stanford University School of Medicine
    1215 Welch Road, Modular G
    Palo Alto, CA 94305-5408
    (650) 725-4481
    Email: Lynn Lam

  3. Fill out the relevant information below and submit it online.

Name (include former names if necessary)

Email

Class Year


If no change in your employment information since last year, please check here and enter your name, email and current home address, then hit "submit":

During the past 12 months, did you work as a:

PA
NP
CNM
Other

What was most of your work?

Clinical
Non-clinical
Combination


I am employed hours per week in patient care.

During your most recent FULL WEEK OF WORK, what percent of your patients were:

  • Over age 65 - %
  • On MediCal (Medicaid) - %
  • Minority ( Hispanic, Asian, Black,
    or American Indian) - %
  • Not fluent in English - %

Where do you perform most of your PA/NP/CNM work?

Employer

Street Address (Employer)

City (Employer)

County (Employer)

State (Employer)
Zip (Employer)

Telephone (Employer)

In what specialty?

Practice type?
Community Clinic
Free Clinic
County or Public Health Department
ER/Walk In
FQHC or FQHC-LA
Health Care for Homeless
Indian Health Services
Inpatient
Private Practice
Rural Health Clinic
School District
Other


Names and addresses of other practice sites during the past year:


Are 50% or more of the patients seen in any of these practices MediCal,
Medicaid, or uninsured patients?

Yes
No

Current Home address:

Street Address

Street Address 2

City

State

Zip

Telephone

  

Footer Links: