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2. In lieu of a signature, HealthLeaders Media requires a unique identifier used only for subscription verification purposes. What is your month of birth?


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4. Which of the following titles most closely describes your position/title? (select only one)
SENIOR MANAGEMENT CLINICAL MANAGEMENT cont.
Administrator Dir. of Ambulatory Services
Chief Compliance Officer Dir. of Clinical Services
Chief Executive Officer Dir. of Emergency Services
Chief Financial Officer Dir. of Inpatient Services
Chief Information Officer Dir. of Intensive Care Services
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OPERATIONS MANAGEMENT VP Medical Affairs (Physician Mgmt /MD)
Asst. Administrator VP Nursing
Chief Counsel FINANCIAL MANAGEMENT
Dir. of Patient Safety VP/Dir. Finance
Dir. of Purchasing INFORMATION MANAGEMENT
Dir. of Quality Chief Medical Information Officer
Dir. of Safety Chief Technology Officer
VP/Dir. Compliance VP/Dir. Technology/MIS/IT
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CLINICAL MANAGEMENT VP/Dir. Media Relations
Chief of Cardiology MEMBER of CONGRESS
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21–49


7. Which best classifies your place of employment by the number of physicians? (select only one)
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3–9 100+
10–25 Not classified by number of physicians
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1–49,999 250,000–499,999
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