Contest is for United States Ultrasound Users only
Required fields indicated by a red asterisk (*)
First name:
*
Last name:
*
Practice name:
*
Position:
*
Address (line 1):
*
Address (line 2):
Suite:
City:
*
State / Province:
Select one
Alabama
Alaska
Alberta
Arizona
Arkansas
British Columbia
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Manitoba
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Brunswick
New Hampshire
New Jersey
New Mexico
New York
Newfoundland
North Carolina
North Dakota
Nova Scotia
Ohio
Oklahoma
Ontario
Oregon
Pennsylvania
Rhode Island
Saskatchewan
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip / Postal Code:
Country:
*
United States
limited to US Ultrasound Users
Language(s) Spoken:
* (use ctrl key to select more than one)
English (US)
Arabic
Basque
Catalan
Chinese (simplified)
Chinese (traditional)
Czech
Danish
Dutch
English (Australia)
English (Canada)
English (Great Britain)
Finnish
French
German
Greek
Hebrew
Hungarian
Italian
Japanese
Korean
Norwegian
Polish
Portuguese (Brazil)
Portuguese
Russian
Slovak
Slovenian
Spanish
Swedish
Thai
Turkish
Vietnamese
Phone: *
Fax:
E-mail Address:
*
Question 1: What are your current reporting capabilities for OB/GYN ultrasound exams?
*
Select one
Transcription
Manual notes in file
Commercial software
If commercial software, which one?
Year purchased:
Question 2: How do you generate and store images? *
Select one
Thermal prints
Digital storage
Film
Videotape
Question 3: How many OB images do you take per study? *
Select one
1 to 10
11 to 15
16 to 20
21 to 25
26 +
Question 4: Have you given any consideration to becoming accredited? *
Select one
Yes, already accredited
Our application is pending
Seriously considering it
Don't know how to proceed
Don't think it is important
Question 5: Is accreditation affecting how you would purchase an ultrasound machine? *
Select one
Yes, significantly
Yes, just a little
Not at all
Not sure
Question 6: If an ultrasound reporting system was available to you that conformed with accreditation guidelines, saved you time and money, improved your clinical information, and cost less than $1.00 per study, would you be interested in purchasing this system? *
Select one
Yes, immediately
Yes, within 3 months
Yes, within 6 months
Yes, within 1 year
Not sure
Question 7: If an office-based, image management system was available to you that conformed with accreditation guidelines, saved you time and money on thermal, prints, and cost approximately $2.00 per study, would you be interested in purchasing this system? *
Select one
Yes, immediately
Yes, within 3 months
Yes, within 6 months
Yes, within 1 year
Not sure
Question 8: Do you have plans to purchase an ultrasound machine? *
Select one
Yes, immediately
Within 3 months
Within 6 months
No plans this year
Possibly in 2002
Please provide Sonultra with your thoughts, comments and ideas.