Durate Waitlist
Thanks for your interest in Durate!
Please fill out this short survey so we can get to know you better -- we'll be in touch with you soon!
Ben and Michael
Co-founders of Durate
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1.
What's your first and last name?
(Required.)
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2.
Are you currently a physician or hospital adminstrator?
(Required.)
Yes, I am a physician
Yes, I am a hospital administrator
No, I am neither a physician nor a hospital administrator
3.
If yes to the previous question, what is the name of your hospital/clinic?
4.
If you are a physician, what field of medicine do you practice?
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5.
How did you hear about Durate?
(Required.)
Word of mouth
Google
Reddit
Other search engine
Other (please specify)
6.
If you were referred to Durate by someone, please enter their name here!
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7.
What email can we reach you at?
(Required.)