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Home
> The Doctors Company Signup Form Page 2
The Doctors Company Signup Form Page 2
Gender
*
Male
Female
Indicate years in the healthcare industry:
*
less than one year
1-5 years
6-10 years
11 or more years
Not Applicable
Which of the following best describes your job category?
*
Administrator
Analyst
Board Member
Clinician Executive
Coordinator
Department Head
Director
Executive
Manager
Staff
Technician
Technologist
Therapist
Other:
Which of the following best describes your discipline?
*
Administration
Case Management
Education
Environmental Services
Finance/Business
Governing Body
Health Information Management
Human Resources
Independent/Group Practitioner
Information Technology
Medical Staff
Nursing Staff
Patient Care Services
Patient Safety
Pharmacy
Physical Therapy
Quality Management
Regulatory Services
Rehabilitation Services
Respiratory
Risk Management
Social Work
Supply Chain Management
Other:
Which of the following best describes the approximate size of your organization?
*
1-100 (full time employees)
101-250
251-500
501-1,000
1,001-5,000
More than 5,000
Not Applicable
Which of the following best describes your organization?
*
Ambulatory Care Facility or Group practice
Ambulatory Care Facility or Single Physician Office
Consulting Practice
Academic Medical Center
Health Plan
Healthcare Association or Society
Healthcare Vendor or Supplier or Manufacturer
Hospital
Military Healthcare Facility
Physician Office
Homecare Organization
Other:
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