Skip to content
Adults with CMN Survey - Clinicians
To assist us in developing a list of CMN clinicians, please can you complete the following survey – it will only take a few minutes.
Thank you for your continued support.
OK
*
1.
What is your gender?
(Required.)
Female
Male
Other (specify)
*
2.
What is your age?
(Required.)
18 - 29
30 - 44
45 - 59
60+
*
3.
In which county do you live?
(Required.)
*
4.
Have you undergone regular monitoring or check ups for your CMN throughout your adulthood?
(Required.)
Always
Usually
Sometimes
Rarely
Never
If you answered never, was this your choice or were you not advised to? Then you can skip to the end of the survey.
5.
Are you being monitored by any of the following consultants?
Dermatologist
Oncologist
Neurologist
Physiotherapist
Other
If other, please specify
6.
Which hospital(s) do you attend?
7.
Please name your consultant(s) and at which hospital(s)?
8.
How much do you trust your consultant(s) in their medical knowledge of CMN?
A great deal
A lot
A moderate amount
A little
Not at all
Please state the name(s) of the consultant(s) you feel have the most knowledge of CMN.
9.
Have you undergone surgery in your adult years?
Yes
No
If you answered yes, please state which hospital(s) and surgeon(s).
Current Progress,
0 of 9 answered
