Visitors Reply Form
Important - please answer all questions
Title:
Name:
Position:
Company/Organisation:
Address:
City/Town:
ZIP / Post code :
Country :
Telephone :
Fax:
E-Mail:
1. Speciality:
General Surgery
Orthopaedic
Gynecology
Urology
Spine
Plastic &Reconstructive Surgery
Cardiovascular
Vascular
Abdominal
Colon & Rectal
Pediatric
Neurogical
ICU/CCU
Infection Control
Post Op Recovery Rm
Product Evaluation
Other
Specify
 What percentage of your surgery performed using Laparoscopy?
 

2. Number of beds in hospital you are affiliated with:

1-50
51-100
101-250
250-500
501-1000
1000 or more
 

3. Number of employees in your organization:

1000 or over
500-999
400-499
300-399
200-299
100-199
50-99
50 or less
 

4. Please indicate your annual expenditure on the following areas of your organization Diagnostic Imaging

Diagnostic Imaging  $ Drugs/Pharmaceuticals $
Endoscopic Instrumentation $ Lasers $
General Surgical/Specialty $ Video Equipment $
Instrumentation $ Others (please specify)
Prosthetics $ $
 

5. Will you use Surgical Technology International to help you make purchasing decisions?

              Yes       No     
 

6. How many people will you share this copy with: 

           

 

7. Which publications do you currently refer to for assistance with your purchasing?

    1. 
    2. 
    3. 
 

8. Are there any individuals within your organization who might like to receive a complimentary copy?

   Name      
   Job Title  
9. Please list any technical instruments/products you are currently in need of:

 

10. What are the three most important topics you would like to read more about in Surgical Technology International?

 

11. Which authors do you think would be the best authorities on the above topic(s)?

 

12. What companies would you like to receive more information about?

 

13. Please list any supplier companies for whom you feel advertising in STI would be beneficial:

  1.
  2.
  3.
  4.
 

14. Do you think Managed Healthcare has been beneficial to medical practicioners?

     Yes          No     
 

15. Do you see technological developments as having a positive impact on healthcare

     Yes          No     
 

16. Please send me further information on the following:

Article Reprints
Editorial Contributions
Advertising
Website
Access to Database
Inclusion in Database
Book Orders
 Other:
 

18. Which brand names of pharmaceutical products do you prescribe the most?

  1.
  2.
  3.
  4.
 

We welcome any comments you may have regarding this publication:

  

    Thank you for your time !