Research about Healthcare Decision Makers in USA Question Title * 1. Contact information Name Company City/Town State/Province Country Linkedin or Social Media link Email Address Phone Number OK Question Title * 2. Have you taken part in an online survey about local cancer care hospitals in recent months? Yes No Don’t know/Not sure OK Question Title * 3. What is your gender? Male Female Non-Binary Other OK Question Title * 4. Please indicate your age. 24 or under 25 – 39 40 – 44 45 – 54 55 – 64 65 – 74 75 – 79 80+ OK Question Title * 5. Do you or does anyone else in your household, work for one of the following types of companies, organizations or departments? An advertising agency A public relations firm or department A market research firm or department A media company such as radio, newspaper, or television A graphic or packaging design firm A media research firm OK Question Title * 6. What is your area of specialization? Dermatology Gastroenterology General surgery Geriatrics Hematology Internal medicine Nephrology Neurosurgery Obstetrics/ gynecology Orthopedic surgery Primary care Pulmonology Urology None of the above Other (please specify) OK Question Title * 7. We are looking to talk to people in different areas. In how many different locations do you practice? 1 2 3 4 5 or more OK Question Title * 8. Please enter the zip code for each practice. And the next, and the next… OK Question Title * 9. How often have you had occasion to refer patients for cancer investigation or treatment in the last 12 months? Please record the number of times. I have not referred any patients in the last 12 months Once Two to five Six to 10 11-20 More than 20 OK DONE