Please read carefully of what we need. We are conducting a phone study this Friday, Saturday and Sunday (June 20th, 21st and 22nd). We are looking for people that work in some type of medical office (this would include: dental office, group medical practice, emergency medical clinic like Urgent Care, medical clinics or nursing home). We are looking for people that work in an office of 10-99 employees. The qualified person would be involved in the purchasing of both office supplies and medical supplies for the office. The phone interview would be on hour (60 minutes) and you would receive $150 for your participation in this study.
If you don't qualify, please forward this to friends and family member that may qualify. If you think you may qualify, please email:
1. Name:
2. When was the last time you participated in a study about medical supplies and equipment?:
A. Less than 6 months ago
B. More than 6 months ago
C. Never
3. Which best describes your place of employment?:
A. Dental Office
B. Solo Medical practice with only one doctor
C. Group medical practice with 2 or more doctors
D. Emergency clinic also known as Urgent Care
E. Medical clinic known as a multi-specialty practice
F. Nursing Home
G. Some other type of office
4. How would you describe your role in purchasing basic office supplies and equipment like paper, toner, pens, printers, etc. for your office?:
A. Sole decision maker
B. You are involved in the decision
C. You are not involve in this decision
5. In the past 60 days, how much has your company spent on basic office supplies?:
5a.What percent of the total spent on office supplies used each of these sales channels list? (must add up to 100%):
A. In person retail outlets: _________%
B. By computer using the Internet: _________%
C. By telephone, fax, or mail using a catalog: _______%
5b. In the past 12 months, which companies have you purchased office supplies and equipment?: (please list all companies used)
6. How would you describe your role in purchasing medical supplies and equipment like gloves, masks, bandages, sponges, monitors, etc for your office?:
A. Sole decision maker
B. You are involved in the decision
C. You are not involve in this decision
7. In the past 60 days, how much has your company spent on medical supplies and equipment?:
7a.What percent of the total spent on medical supplies and equipment used each of these sales channels list? (must add up to 100%):
A. In person retail outlets: _________%
B. By computer using the Internet: _________%
C. By telephone, fax, or mail using a catalog: _______%
7b. In the past 12 months, which of the following companies have you purchased medical supplies and equipment from?:
A. Cardinal Health
B. Corporate Express
C. Henry Schein
D. Medical Arts Press (sub. of Staples)
E. Medline Industries
F. OfficeMax
G. Ownes & Minor
H. Paterson Dental
I. PSS World Medical
J. Other (Please specify)________________
8. How long have you worked for your employer and been involved in the ordering of office and medical supplies?:
9. Including yourself, how many people are employed at your company?:
10. I would like you to rate each of the following statements on a scale of 1 to 5, where 1 means you "completely disagree", and 5 means you "completely agree":
A. General speaking, I enjoy expressing my thoughts and ideas: ____
B. I like public discussion and debates on various topics: ____
C. I am comfortable speaking to others about issues: ____
D. I have my opinions on most topics and I like sharing them with others: ____
E. Others who know me consider me to be well versed and articulate: _____
11. Mailing address: (this would be the address we would mail your check to)
12. Phone numbers: (day and evening)
"Borrowed" Thanks Charley01
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