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| Item | Response options |
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| What is your gender? | - Male - Female |
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| What is your age: | - Numerical response (18–99) |
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| What is your ethnicity? | - Hispanic or Latino - Not Hispanic or Latino |
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| What is your race? (You many select multiple answers for this question) | - White - Black or African American - Asian - Native Hawaiian or Other Pacific
Islander - American Indian or Alaskan Native |
|
| Are you a medical student in the USA? | - Yes - No
|
|
| What is your year in medical school? | - MS-I - MS-II - MS-III - MS-IV - NA |
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| What medical school do you attend? | - List response of all US medical schools - Other (with open response) |
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| Is coursework in CAM offered at your medical school? | - Yes - No - Do not know |
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| Would you like to receive more education about CAM as part of your medical education? | - Yes - No |
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| Do you feel that the education you have received regarding CAM as part of your | - Yes |
| medical education has been
adequate? | - No |
|
| Have you studied CAM?
(You may select more than one answer for this question.) | - As part of the core coursework at your
medical school - As an elective at your medical school - Outside of your medical school - Never |
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| Have you ever treated yourself with CAM? | - Yes - No |
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| Have you ever treated someone else with CAM? | - Yes - No |
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| Have you ever received treatment from a provider of CAM(e.g., an acupuncturist, a chiropractor, etc.) | - Yes - No |
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| Have you ever personally used any of the following forms of CAM? | |
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