New York State Education Department
Midwife Survey
Center for Health Workforce Studies
School of Public Health, University at Albany
This questionnaire is a supplemental part of your registration application. If you complete the survey online, you do not have to complete the paper survey you received in the mail.
Your responses will be maintained in a strictly confidential manner by the Center for Health Workforce Studies (http://chws.albany.edu) at the School of Public Health, University at Albany, SUNY. The responses will be analyzed and presented only in aggregate form to document changes in the midwifery workforce in New York.
Item 2 asks for your NYS midwifery license number. This can be found on your registration application. Thank you for taking the time to complete this survey.
At any point during the survey, you can click the Save button at the bottom of the page to save your partial responses and return at a later time to complete the survey.
BASIC INFORMATION
1. DATE COMPLETING SURVEY:
Month
Year
January
February
March
April
May
June
July
August
September
October
November
December
2011
2012
2013
2014
2. NYS MIDWIFERY LICENSE NO:
[Help]
3. NYS RN LICENSE NO:
[Help]
(If applicable)
4. YEAR OF BIRTH:
Male
Female
5. GENDER: