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Membership Type *	CSA Membership - Affiliate (free) Members only access for Affiliates CSA Membership - Colorado ($250.00) Members Only Access for Active Registered Members who live in Colorado. CSA Membership - Out of State ($100.00) Members Only Access for those who live outside of Colorado. CSA Membership - Resident (free) Members Only Access for Residents CSA Membership - Retirees (free) Members Only Access for Retirees
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Title MD, PhD, etc.
Practice Model Please tell us about your anesthesiology practice	Academic/Teaching Government Private Practice - Solo Private Practice - Group
Use Anesthesia services What percent of your practice provides anesthesia services during the Anesthesia Care Team (ACT) model?	All care is personally performed by a physician. Less than 50% ACT model. Greater than 50% ACT model. 100% ACT model.
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