AHNS Otobase Survey

Please give us the following information:
Your name
Your email
Your phone number

Have you installed Otobase?
Yes
No

How long have you used Otobase?

Approximately how many patients have you entered into Otobase?
Would you be interested in joining a collaborative study group of other Otobase users?
Yes
No

Please select one or more of the following suggested areas of collaborative study that may be of interest to you:

Early stage (T1) glottic cancer.
Selective neck dissection in the N1/N2 neck.
Adenoid cystic carcinoma
Esthesioneuroblastoma
Ethmoid cancer
Other

If there is another area(s) of study that interests you, please indicate it in the space below:

Additional Comments: