Medical Construction & Design
  Medical Construction & Design is free to qualified professionals. Summary Description
  To apply for a FREE subscription to Medical Construction & Design, please answer ALL of the questions on the form below.
  The magazine publisher determines qualification and reserves the right to limit the number of free subscriptions.
  Geographic Eligibility: USA


 
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  What is the approximate number of employees in your company? (select only one)
 
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2. Please indicate your primary business/industry: (select only one)
Construction/General Contractor Supplier/Manufacturer
Engineering Government
Architecture Education
Interior Design Other (please specify)
Hospital/Health Care Facility


3. Please indicate which best describes your title: (select only one)
Architect CFO, COO
Engineer Facility Manager
Interior Designer Vice President/Director
Project Manager Other (please specify)
Owner, President, CEO


4. Which types of facilities do you or your firm work with? (select all that apply)
Hospitals University/Medical Schools
Surgery Centers Other (please specify)
Medical Office Buildings
Nursing Homes


5. How much will your organization spend on renovation/construction projects in the next 12 months? (select only one)
Up to $1,000,000 $10 million - $24,999,999
$1 million - $4,999,999 $25 million - $100 million
$5 million - $9,999,999 More than $100 million


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OR:    Name of the school you last attended:
Which of the following BEST describes the primary business of your organization or division? (select only one)
A. HEALTHCARE PLAN, PAYOR & ADMINISTRATIVE ORGANIZATIONS:
HMO/PPO/PSO/Insurance Company
Medicare/Medicaid/Governmental Plan
Supplemental/Carve-Out Insurance Plan (Dental/Vision/Behavioral Health)
Pharmacy Benefits Management (PBM) including Medicare Part D PDP
Third Party Administration (TPA)
Utilization Review Firm
Contract Management Firm
Group Purchasing Organization (GPO)
Employee Benefits Management (EBM) Firm/Consultant
Other Healthcare Plan, Payor & Administrative Organization
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B. HEALTHCARE PROVIDER ORGANIZATIONS: (An entity that directly treats patients)
Integrated Health Organization (IHO) (multi-hospital/practice settings; same ownership)
Integrated Delivery System (IDS) (multiple practice settings; same ownership)
Integrated Health Network (IHN) (multi-hospital; separate ownership)
Multi & Large Group Practice (50+ physicians)
Multi & Large Group Practice (less than 50 physicians)
Independent Hospital (300+ beds)
Independent Hospital (less than 300 beds)
Independent Practice Association (IPA)
Medical Clinic (50+ physicians)
Medical Clinic (less than 50 physicians)
Long-term Care Facility or Multi-Facility
Home Healthcare Organization
Other Healthcare Provider Organization
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C. INDEPENDENT CONSULTANT
D. NON-HEALTHCARE EMPLOYERS OF: (Aerospace, Automotive, Banking/Financing, Construction, Consumer Goods, Energy, Federal & State Government, Food/Grocery, IT–Hardware & Software, Retail)
5,000+ Employees
1,000 - 4,999 Employees
200-999 Employees
E. OTHER
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Which of the following titles & specialties BEST describes your highest current management position in the business organization selected in the above question? (select only one)
NON-CLINICAL EXECUTIVE:
Chief Executive: CEO/COO/President/Executive Director/Owner/Principal/VP/Director
Managed Care Executive: Chief/VP/Director
Administrative Executive: VP/Director
Financial Executive/Contracting Executive/Industry Relations Executive: CFO/VP/Director/Treasurer/Controller
Information Technology & Intelligence Services Executive: CIO/VP/Director (Software, Hardware, Web, Data Processing, Technology Assessment)
Medical Records Executive: VP/Director
Marketing Executive: CMO/VP/Director
Sales Executive: CSO/VP/Director
Patient Relations/Member Services Executive: VP/Director
Human Resources Executive: VP/Director
Employee Benefits Executive: VP/Director
Legal/Regulatory/Affairs Executive: Chief Counsel/VP/Director
Risk Management Executive: VP/Director
Other Non-Clinical Executive: VP/Director
Please specify for Other:
CLINICAL EXECUTIVE:
Medical Director
Chief of Medicine/Chief of Staff
VP/Director/Chief of Medical Affairs
Clinical Program Director/Services VP/Director (Specify: e.g., Oncology, Sports Medicine, Transplant, Disease, ER, Trauma, Wellness, Physical Therapy, Radiology, etc.)
Please specify:
Pharmacy/Formulary Director/Formulary Committee Chair
VP/Director/Chief of Pharmacy Services
Drug Information Officer/Clinical Pharmacist
VP/Director of Nursing/Chief of Nursing Affairs
Utilization Review/Quality Assurance VP/Director
Case Management VP/Director
Provider Relations VP/Director
Other Clinical Executive: VP/Director
Please specify for Other:
  Are you currently a P & T Committee member/presenter/contributor? Yes     No
  Total number of lives covered if at a Managed Care Plan/Payor Organization:
  Do you presently play a role in Pharmacy Benefits Design/Structure, Drug Choice and/or Implementation? Yes     No
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