Join Now – Medical Decision Makers

Do you own or rent your place of residence?*
Which classification best describes your total pre-tax household income?*
What is the value of the investment accounts you own? (Not including home or 401K)*
What is the highest level of education you have completed?*
How many domestic trips have you taken in the past 12 months where you traveled by airplane?*
How many vehicles do you have in your household? (Please select year/make/model/vehicle type/deal type for each vehicle you choose).*
Vehicle 1 Information
Year*
Make*
Model*
New/Used*
Vehicle 2 Information
Year*
Make*
Model*
New/Used*
Vehicle 3 Information
Year*
Make*
Model*
New/Used*
Vehicle 4 Information
Year*
Make*
Model*
New/Used*

General Medical
Are you board-certified or eligible for board certification?*
How many years of experience do you have in your current specialty?*
As part of your current role, are you involved in selecting any of the following vendors? Please select all that apply. *
- Medical supplies provider
- Janitorial services provider
- Catering services provider
- Pharmacy provider
- Employee benefits provider (non-insurance)
- Software/information technology provider
- Insurance provider
- None of the above
Which best describes the practice or organization in which you primarily work?*
Which of the following best describes the area in which your primary practice or organization is located?*
Is your practice or organization privately owned, hospital-owned, part of a managed care network, or something else?*
How many beds are there at your practice or organization?*
Have you sold a practice in the last 3 years?