Thank you for your participation in the Maryland State Opioid Response (MD-SOR) Evaluation! Your continued support of data collection efforts is extremely appreciated. Completing this form provides the evaluation team at University of Maryland School of Medicine with essential information including your client's email address for incentive delivery, as well as the full 6 Month Follow Up GPRA Interview.

This is a HIPAA-compliant platform.

For any line that requires specification, please be sure to write in or select an answer.

If you have any questions, please contact Wendy Potts at WPotts@som.umaryland.edu or 410-706-6638.

Loading... Loading...
You have selected an option that triggers this survey to end right now.
To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.