E-mail Address:  Name:
Category:

1. Does your practice currently use the Internet for any of the following services? (Please check ALL that apply)

General medical research and news
Purchase medical products
Access pharmaceutical information (substitutions, interactions, dosage)
Order and verify prescriptions
Diagnostic reporting (ordering or looking up lab, radiology, or other testing)
Submit and check the status of claims
Receive payments or reimbursements
Communicate with patients (sending and receiving e-mail to and from patients)
Electronic medical records (storing patient medical history online)
Document patient encounters (take patient history or progress notes online)
None of the above

2. Please indicate ALL of the people in your practice who use the Internet.

Physicians
Physician assistants
Nurses
Nursing assistants
Office managers
Coders

3. Which topics below are of interest to you?  (Please check ALL that apply.)

Point of care diagnostic testing
Medical records privacy
Telemedicine
Physician-patient e-mail
Continuing medical education
New uses for FDA approved pharmaceuticals
Physician office equipment
New pharmaceutical approvals
Announcements of new clinical trials
Antibiotics
CLIA guidelines
Contraceptives
Online claim processing

4. How much does your office spend on medical supplies each month?

$0
$100
$250
$500
$1000
Don't know

5. How much does your office spend on practice management software each year?

Less than $100
$101 to $250
$251 to $500
$501 to $750
$751 to $1000
Over $1000

6. What is your practice's office manager's annual salary range?

Less than $20,000
$20,001 to $25,000
$25,001 to $30,000
$30,001 to $35,000
$35,001 to $40,000
Over $40,000

7. How many physicians are located in your practice organization?

1 to 4
5 to 10
11 to 20
21to 50
over 50

Final question: Can you receive HTML e-mail? Yes No

 
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