Below is a sample of the emails you can expect to receive when signed up to SCOPE of Pain.
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Data Name | Data Type | Options |
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Fax | ![]() | |
First name | ![]() | |
Last name | ![]() | |
Title | ![]() | |
Password | ![]() | |
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Home address | ![]() | |
City | ![]() | |
State | ![]() | |
Region | ![]() | |
Country | ![]() | |
Zipcode | ![]() | |
Date of birth | ![]() | |
State Required | ![]() | Select ... |
Country Required | ![]() | Select ... |
Degree (As you want it to appear on your certificate) Required | ![]() | Select ... |
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What is your profession? Required | ![]() | Select ... |
Are you affiliated with any of these organizations? Required | ![]() | Select ... |
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Which best describes your practice area? Required | ![]() | Select ... |
Do you perform surgical procedures? Required | ![]() | Select ... |
How many years have you been in clinical practice? Required | ![]() | Select ... |
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Is your practice recognized by NCQA as a Patient Centered Medical Home (PCMH)? (Learn more about PCMH) Required | ![]() | Select ... |
Is your practice recognized by NCQA as a Patient Centered Specialty Practice (PCSP)? (Learn more about PCSP) Required | ![]() | Select ... |
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![]() | Select ... I primarily provide long-term continuity care to patients (e.g., primary care) I primarily provide short-term episodic care to patients (e.g., emergency or urgent care, hospitalist care, surgical care) Neither/not applicable Required Misc What was your reason for participating in SCOPE of Pain? (Check all that apply) Required | |
![]() | State mandated (licensing purposes) | |
![]() | Mandatory in workplace (internal policy) | |
![]() | Mandatory in profession (association policy/regulatory or accreditation purposes) | |
![]() | Informally mandatory (workplace or association strongly suggested/encouraged participation) | |
![]() | Not mandatory – Voluntarily participated due to personal interest/professional improvement/other | |
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