CURRENT SPONSORS

Survey

Fill in all fields below, check all appropriate

All fields must be completed in order to qualify for the drawing.

Specialty
First Name	Last Name
Phone
Email

1: Does your office do waived testing?

YesNo

2: Does your office do moderately complex testing?

YesNo

3: Does your office do high complexity testing?

YesNo

4: Which Instruments do you have in your office or lab?

Blood GasCentrifugeChemistryDopplerECGHematologyHolterImmunoassaySpirometryStressTympanometryUltrasoundX-ray
5: How many CBC's do you order per day?

5-1011-2021-40

CBC Other

6: Do you run or order Lipid Profiles?

YesNo

If Yes, how many per month?

<20>60 21-4041-60

7: Do you run or order Liver or Kidney Profiles?

YesNo

If Yes, how many per month?

<20>6021-4041-60

8: Do you run or order Comprehensive Chemistry Profiles?

TrueFalse

If Yes, how many per month?

<20>6021-4041-60

9: Which instruments do you plan to purchase or replace?

Blood GasCentrifugeChemistryDopplerECGHematologyHolterImmunoassaySpirometryStressTympanometryUltrasoundX-ray
10: Regarding Question #9 my need is

11: What is your monthly testing volume on the following?

Tests/Month

<20>6021-4041-60

T4/T-Uptake

<20>6021-4041-60

Total T4 Only

<20>6021-4041-60

TSH

<20>6021-4041-60

Serum Pregnancy

<20>6021-4041-60

Quantitative hCG

<20>6021-4041-60

12: Which of the following distributors do you use?

Bergen BrunswigCardinal HealthFisher HealthcareGeneral MedicalHenry ScheinMcKessonMercedes MedicalOwens MinorPSS (Physicians Sales and Service
13: Will you use Physicians Office Resource online again as a source for product information?

YesNo

14: Did you find the Physicians Office Resource magazine or website useful or helpful in learning more about running your practice or lab?

YesNo

15: Have you ever purchased a product as a result of your product search through POR the magazine or website?

YesNo

Thank you for your input, please click the submit button and your name will be entered to win the drawing for an Apple iMac.

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