JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Incubator 5-year Anniversary Survey
Fill out this short survey to provide feedback and enter our 5-yr anniversary giveaway
* Indicates required question
Email
*
Record my email address with my response
Name (First, Last) (not required, but we'd like to mail you a prize if you win the drawing!)
Your answer
Age Group
*
Choose
Under 18
18-24
25-34
34-44
45-54
55-64
65+
Email Address (not required unless you want to be entered to win a prize!)
Your answer
Location (City, Country)
Your answer
If you would like to participate in our drawing for giveaways, please leave a mailing address so that we can send prizes directly to winners! (not required unless you want to be entered to win a prize!)
Your answer
Professional Information
*
Choose
Allied Health Professional
Fellow
Nurse
Nurse Practitioner
Parent
Pharmacist
Physician
Resident
Student
If you are a healthcare provider, what is the name of your institution?
Your answer
If you are a physician, what is your career level?
*
Choose
Early career
Mid Career
Well Established
What is your favorite episode format?
*
Choose
Journal Club Short
Journal Club (Long Episodes)
NeoNews
Interviews
Tech Tuesday
Mini-series
From the Heart
Do you listen to The Incubator in other languages?
*
Farsi
French
Portuguese
Spanish
No, I only listen to the English edition
How likely are you to recommend The Incubator to a friend or colleague?
*
1
2
3
4
5
6
7
8
9
10
Do you also subscribe to the Neonatology Review Podcast?
*
Yes
No
How frequently do you listen to The Incubator?
*
Choose
A few times a month
A few times a week
Daily
Monthly
Never
Rarely
Weekly
Are there any barriers you perceive to listening to the podcast?
(Select all that apply)
*
None
Difficulty accessing the podcast
Lack of time
Not enough information on topics of interest
Poor audio quality
Prefer reading articles over listening to podcasts
Other:
What are the topics we haven't yet covered that you would like to see represented on the podcast?
Your answer
What are the topics we may have already discussed that you would like us to revisit?
Your answer
Are there any other educational resources that could enhance your practice and that you would like to see our team take on?
Your answer
Any general feedback for our team?
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. -
Terms of Service
-
Privacy Policy
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report