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How did you find out about us? -- Please Choose One -- Direct Mail Word of Mouth Web Link Emailed by Friend Email Web Banner Business Card Other Newspaper Online news Trade Show Journal/Magazine Search Engine Other HealthLeaders Magazine
What segment of healthcare do you work in? -- Please Choose One -- Hospital Health System (IDS/IDN) Physician Org (IPA/MSO/PHO/Clinic) Health Plan/Insurer (HMO/PPO/MCO/PBM) Ancillary Provider (Home health, SNF, Lab, Rehab, LTC, Postacute, etc) Pharmacy/Pharmaceutical Employer/Purchaser Government Education/Academic Group Purchasing Org Consulting/Law/Financial Services Technology Products/Services Vendor/Supplier Trade Assn, Accrediting Body Media/Publishing/PR Other
What is your title? -- Please Choose One -- Chief Executive Officer President Administrator Exec. Dir/Partner/Board Member Chief Operations Officer Chief Financial Officer Chief Information Officer Chief Technology Officer Chief Counsel Chief Compliance Officer Chief Medical Officer Chief of Staff Medical Director VP Medical Affairs (Physician Mgmt) Chief Purchasing Officer VP/Director of Human Resources Purchasing Director MD/Physician Pharmacist Nurse (NP/LPN/LVN/CNA/RN) Attorney/Consultant PhD/Professor Employee/Staff Assistant Administrator VP/Director Operations/Administration VP/Director Finance VP/Director Technology/MIS/IT VP/Dir. Compliance Other Legal Counsel VP/Dir. Marketing/Sales/Business Dev. Dir., Marketing/Sales/Business Dev. Chief Nursing Officer VP Clinical Services Chief Medical Information Officer Principal Owner VP Clinical Informatics VP Clinical Quality VP/Dir. Media Relations Director of Patient Safety Director of Quality Director of Safety VP of Nursing Director of Nursing Director of Ambulatory Services Dir., Surgical/Perioperative Svces. Director of Emergency Services Director of Intensive Care Services Director of Inpatient Services Director of Rehabilitation Services Director of Clinical Services Chief of Orthopedics Senator U.S. House Representative Chief of Neurology Chief of Cardiology Chief of Oncology Chief of Radiology Other
Which best classifies your place of employment by the number of beds? -- Please Choose One -- 1-199 200-499 500-999 1000+ n/a
Which best classifies your place of employment by the number of sites within your organization? -- Please Choose One -- 1-5 6-20 21-49 50+ n/a
Which best classifies your place of employment by the number of physicians? -- Please Choose One -- 1-2 3-9 10-25 26-49 50-99 100+ n/a
Which best classifies your place of employment by the number of enrollees? -- Please Choose One -- 1-49,999 50,000-99,999 100,000-249,999 250,000-499,999 500,000 n/a
