Clinical Respiratory Protection Survey Clinical Respiratory Protection Survey Please complete the following survey regarding Washington University’s Clinical Respiratory Protection Program. The results of the survey will be used to further improve clinical respiratory support and ensure the safety of Washington University’s providers and staff. Please forward the survey to the appropriate contact if you are unable to answer clinic specific questions. Enter Your Name * Enter Contact Information (E-mail or Phone) Do any of your healthcare providers perform aerosol-generating procedures? Yes No Select a Department * ANESTHESIAFACULITY PRACTICE PLANINTERNAL MEDICINENEUROLOGYNEUROSURGERYOBSTETRICSOPHTHALMOLOGYORTHOPEDIC SURGERYOCCUPATIONAL THERAPYOTOLARYNGOLOGYPEDIATRICSPSYCHIATRYPHYSICAL THERAPYRADIOLOGYRADIATION ONCOLOGYSURGERYWUCAOther Select a Department Check all Clinics that apply PAIN MGMT CENTER - BJWCH PAIN MGMT CENTER - CAM PAIN MGMT CENTER - MBMC OtherOther Check all Clinics that apply CSCC - 2D CAM - 5A 1110 HIGHLANDS PLAZA DR EAST SUITE 375 OtherOther Check all Clinics that apply CARDIOLOGY - BJWC DERMATOLOGY CENTER - COH MOHS SURGERY - DERM DERMATOLOGY - BALLAS ROAD CUTANEOUS SURGERY CTR - BJWC DERMATOLOGY CENTER - BJWC BARNES-JEWISH ST PETERS DERMATOLOGY CENTER DIABETES CENTER - CAM CHROMALLOY KIDNEY CENTER BJH DIALYSIS CENTER - 4205 FOREST PARK PKWY NORTH COUNTY DIALYSIS CENTER DIGESTIVE DISEASE CENTER - MoBap INFECTIOUS DISEASES - TAB Ext COVENANT PLACE SITEMAN PHYSICIAN SUITES - CAM SITEMAN TREATMENT CTR - CAM SITEMAN CANCER CENTER - BJWC SITEMAN SOUTH COUNTY SITEMAN CANCER CENTER - ST PETERS SITEMAN - SHILOH SITEMAN - CHRISTIAN NORTHWEST WUCOMPLETE CARE - BJWC MED MULTISPECIALTY CTR - CAM MEDICINE SPECIALTY CTR - BJWC SC CAM MEDICINE MULTISPECIALTY,STE 2300 HEART & VASCULAR CTR - CAM GASTROINTESTINAL CENTER - CAM LUNG CENTER - CAM PFT LAB – 8 CAM OtherOther Check all Clinics that apply NEUROLOGY CLINICAL RESEARCH UNIT - BJC SOUTH PEDIATRIC NEUROLOGY SLCH NEUROLOGY - HEALTHKEY CAM NEUROSCIENCE CENTER NEURODIAGNOSTICS – 6 CAM NEUROPSYCHOLOGY CLINIC - 4444 CENTER 40 OtherOther Check all Clinics that apply PEDIATRIC NEUROSURGERY - SLCH SPINE CENTER - CAM NEUROSURGERY - BJWC OtherOther Check all Clinics that apply WOMEN`S HEALTH CENTER - COH WOMEN'S HEALTH CENTER - CAM SOUTH COUNTY CENTER FOR WOMEN'S WELLNESS & FETAL HEALTH- MBMC GYNECOLOGIC TREATMENT CENTER - CAM 13C REPRO ENDOCRINOLOGY - 4444 FOREST PARK PW OtherOther Check all Clinics that apply WU EYE CENTER - COH EYE CENTER - BJWC WU EYE CENTER - CAM SOUTH COUNTY CHILDREN'S EYE CENTER - CSCC CHILDREN'S EYE CENTER - SLCH UNIVERSITY EYE SERVICE - MCMILLAN BLDG WU EYE CENTER - FOREST PARK SUITE 27 BJC VISION CENTER - BJH SOUTH BJC VISION CENTER - CAM OtherOther Check all Clinics that apply ORTHOPEDIC SURGERY CTR - CAM SPINE SHOULDER CENTER - CAM ORTHO - SLCH ORTHO -CSCC ORTHOPEDICS CHESTERFIELD ORTHO - BJWCH ORTHO -LIVING WELL CENTER ORTHO - PROGRESS WEST OtherOther Check all Clinics that apply WU OT FOREST PARK MILLIKEN HAND REHABILITION CENTER OAKLAND CLINIC PARAQUAD HEALTH & WELLNESS CENTER CHESTERFIELD MILLIKEN HAND OtherOther Check all Clinics that apply AUDIOLOGY AT CID CAM SOUTH COUNTY - SUITE 1700 EAR, NOSE AND THROAT - BJWCH FACIAL PLASTIC SURGERY - BJWCH EAR, NOSE & THROAT - CAM EAR, NOSE, AND THROAT - CHNE ENT CENTER - SLCH THE CENTER FOR HEARING AND BALANCE DISORDERS - SUITE 58W OtherOther Check all Clinics that apply PEDIATRICS SLCH (SUITE C) PEDIATRICS SLCH (SUITE D) PEDIATRICS CSCC PEDIATRIC MULTISPECIALITY CENTER - CHNE HEM-ONC - SLCH 9TH FLOOR HEART STATION - SLCH PFT LAB - SLCH THE SPOT - LACLEDE THE SPOT - JENNINGS PEDIATRIC MULTISPECIALITY CENTER - RICHARDSON RD MULTISPECIALITY - 1313 CROSS ST., SHILOH, IL OtherOther Check all Clinics that apply PSYCHIATRY - WEST PAVILION PSYCHIATRY - CENTRAL INSTITUTE FOR THE DEAF PSYCHIATRY - 4444 FOREST PARK COH - SUITE 441 OtherOther Check all Clinics that apply PHYSICAL THERAPY - 4444 PHYSICAL THERAPY - TRISL PHYSICAL THERAPY - DANFORTH CAMPUS PHYSICAL THERAPY - PROGRESS WEST OtherOther Check all Clinics that apply INTERVENTIONAL RADIOLOGY - BJC SOUTH RADIOLOGY - BJSP OtherOther Check all Clinics that apply RADIATION ONCOLOGY - BJWC RADIATION ONCOLOGY - SOUTH COUNTY RADIATION ONCOLOGY - CAM RADIATION ONCOLOGY - CHRISTIAN NORTHWEST RADIATION ONCOLOGY - ALTON MEMORIAL HOSPITAL RADIATION ONCOLOGY - MEMORIAL HOSPITAL EAST RADIATION ONCOLOGY - ST PETERS OtherOther Check all Clinics that apply SLCH SUITE A BREAST HEALTH CENTER - CAM PLASTIC SURGERY CENTER - CAM VASCULAR LAB - 8CAM UROLOGIC SURGERY CTR - CAM UROLOGIC SURGERY - BJSP WEST COUNTY PLASTIC SURGEONS - BJWC UROLOGIC SURGERY - BJWC GENERAL SURGERY - BJWC VASCULAR SURGERY AND PODIATRY - 969 N MASON UROLOGICAL SURGERY - CHNE GENERAL SURGERY - CHNE CARDIAC SURGERY & VASCULAR SURGERY - CHNE UROLOGIC SURGERY - PROGRESS WEST PLASTIC SURGERY - ALTON, IL UROLOGY - ALTON, IL VASCULAR SURGERY - MATERNITY PARKVIEW TOWER VASCULAR LAB - SOUTH COUNTY CAM VASCULAR LAB - CHNE OtherOther Check all Clinics that apply ARCH PEDIATRICS BLUE FISH PEDIATRICS CLOVERLEAF PEDIATRICS FENTON PEDIATRICS FOREST PARK PEDIATRICS GRANT MEDICAL CLINIC KIDS DOCS NASH PEDIATRICS NORTHWEST PEDIATRICS - 1660 WEST MEYER ROAD NORTHWEST PEDIATRICS - 11 GARVEY PARKWAY NORTHWEST PEDIATRICS - 1265 GRAHAM ROAD O'FALLON PEDIATRICS PREMIER PEDIATRICS PURELY PEDIATRICS SOUTHWEST PEDIATRICS UNIVERSITY INTERNAL MEDICINE & DIABETES ASSOCIATES UNIVERSITY PEDIATRIC ASSOCIATES UNIVERSITY PERSONAL PHYSICIANS WESTSIDE PEDIATRICS WOODS MILL PEDIATRICS OtherOther Please select all aerosol-generating procedures that apply Intubation Extubation Bronchoscopy Cauterization (Smoke generation) ENT surgical procedures TEE EGD Colonoscopy Vaginal deliveries Other high risk surgical procedures that involve insufflations (laparoscopy, thorascopy) Suctioning None OtherOther Do any of your healthcare providers provide direct care to patients who are COVID positive or under investigation [PUI]) for COVID-19 and are critically ill requiring ICU-level care? Yes No Please provide the name of a contact(s) for follow-up questions. The contact person can be a respiratory protection captain or an employee familiar with the department’s clinical procedures. * Comments This form is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply. Submit Δ