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


 
1. Do you wish to receive a FREE subscription to Eyecare Business?
Yes     No


First Name:
Last Name:
Job Title:
(Ex: Director, Vice President, Project Manager, etc.)
Company:
(Please provide your Company Name in full: abbreviations could disqualify you)
Street Address:
Division/Mail Stop:
City:
State:
Country:
(Note: If your country is not listed above, subscriptions are not currently available at your location.)
Zip/Postal Code:
Business Phone:
Business Fax:
Email Address:
(Note: Valid email address is required or you could be disqualified.)

  What is the approximate number of employees in your company? (select only one)
 
Yes, please auto-fill my contact information for other publication qualification forms.


2. May we contact you via email?
Yes     No


3. May we contact you via email on behalf of ophthalmic industry on topics pertinent to you?
Yes     No


4. May we contact you via fax?
Yes     No


5. Please check the ONE category that best describes your business/professional activity: (select only one)
DISPENSING OPTICIAN OPTOMETRIST cont.
Self-employed/owner Independent affiliated with retail corporation
Employee of retail corp(chain) Employee with retail corporation
Employee of independent optician Employee of O.D.
Employee of independent O.D. Employee of M.D.
Employee of independent M.D. Other optometrist (please specify)
Other dispensing optician (please specify)
OPHTHALMOLOGIST
OPTOMETRIST OPTICAL LAB/WHOLESALER
Solo practice EXECUTIVE/BUYER AT CHAIN HEADQUARTERS
Group practice OTHER (please specify)
Corporate franchise


6. What is the wholesale price range of the majority of the eyeglasses sold at your business? (select one only)
Over $150 $51 - $100
$100 - $150 Under $50


7. At your practice, of the spectacle lenses you dispense, what percentage are A/R coated?
%


8. What are the lens processing capabilities on-site at your business? (select all that apply)
Finishing (edging) Surfacing
Casting None


9. Do you buy, specify, approve or influence the purchase of contact lenses?
Yes     No


10. Do you fit contact lenses?
Yes     No


11. In lieu of a signature, we require a personal identifier. To verify that you submitted this application please enter below in what state were you born:


  Would you like to receive EMAIL notices of other print or online publications, and other relevant offers from TradePub.com?
Yes     No
  Sign up for special offer alerts from select partners featuring the latest products and services you are interested in.
Yes     No

 
Related FREE Offers from TradePub.com: Check those you wish to receive.

Pharm Rep Direct is the free biweekly newsletter from the editors of Pharmaceutical Representative. It covers new developments and cutting-edge advice from the world of sales management and training, as well as regulatory updates, must-know court cases, key statistics, exclusive interviews - you can find everything you need here, in Pharm Rep Direct. Note: Offer Valid in the United States, Canada, Mexico, and International Only.
  Which of the following best describes your industry? (select only one)


Please specify for Other:
  Which of the following is closest to your job function? (select only one)


Please specify for Other:
  What is the approximate number of employees in your company? (select only one)

Free Web Design Quotes! Let the industry's top vendors compete for your business! Save time and money by comparing FREE multiple quotes for Web Design with only 1 form. All vendors are pre-screened and pre-qualified. There is No Cost and No Obligation. Submit a request now and get the best website for your business! Note: Offer Valid in the United States Only.

The Total Economic Impact™ of eStara Click to Call: In this report, Forrester Research conducted in-depth analysis of multiple implementations of eStara Click to Call. The financial analysis in this study illustrates a way to evaluate the value of Click to Call:
  • proven ROI
  • a payback period of between seven and 14 months
  • an improvement in the conversion rate for leads generated by Click to Call
Written by Forrester Consulting, Hosted by eStara Connections from ATG

Note: Offer Valid in the United States and Canada Only.
  Which of the following is closest to your job function? (select only one)


Please specify for 'Other'.
  What is the number of employees in your entire organization? (select only one)
  Please check the box below if you do not want to receive future email messages from Art Technology, Inc.
No
  Do you currently conduct transactions (sales, form completion, etc) on your Web site? (select only one)
  Which of the following are part of your customer service offerings? (select all that apply)
Click to Call Contact Us form
Live Chat Other (please specify)
FAQs

Request your free White Paper: Medical Grade Mobility. Learn how to deliver uninterrupted wireless at every point of care. Next generation point-of-care applications depend on reliable wireless communications at every point of care. While many hospitals have already deployed wireless LANs in some areas of their facilities, few of them have ubiquitous coverage, and fewer-still have the wireless mobility necessary to deploy point of care applications successfully. The white paper outlines the business and patient care benefits of mobile point-of-care applications, and discusses the challenges of enabling the Medical-Grade Mobility they require, to deliver highest return on investment and better patient outcomes. Note: Offer Valid in the United States Only.
  Number of beds in your organization: (select only one)
500 and up 100 - 199
200 - 499 1 - 99
  Please indicate type of Facility / Service / Firm: (select only one)
Hospital/Multi-Hospital System Managed Care Organization (HMO, PPO, Healthplans)
Integrated Delivery System/Health Network Insurance Company
University/Teaching Medical Center/Hospital Third Party Administrators (TPA)/Self-Insured Employer
Military/Government Medical Center/Hospital Pharmacy/Independent Lab
Clinical/Group Practice IT Consulting/Systems Integration
Physician Organization (IPA/PHO) Consulting Firm
Ambulatory Care Center VAR/Vendor of Systems
Long-Term/Sub Acute Care Facility/Nursing Home/Rehab Other (please specify)
Home Health Care Agency
  Please select the category that best describes your title: (select only one)
General and Financial Management Information Management cont.
CEO, President, Executive Director, Administrator Other IT Personnel (please specify)
CFO, Finance Director/Manager
CSO/Security Officer/Director Network/MIS/Data Processing Director/Manager
Planning Officer/Director Health Information Director/Manager
Marketing Officer/Director Coding/DRG Director/Manager
COO, VP, Assistant Administrator Systems Administrator/Analyst/Network Specialist/Project Manager
CCO, Compliance Director/Manager Clinical Management
CPO/Purchasing/Materials Management Director/Manager Chief of Staff/Medical Director/VP of Medical Affairs
Quality Officer/Director Chief of Pathology/Pathologist
Other Administrative Title (please specify) Chief of Radiology/Radiologist
Other Clinical Administration (please specify)
Information Management
CIO, VP of Information Systems, Tech Officer Chief of Laboratory Services/Lab Administrator
Chief of Medical Records/Medical Records Manager Chief of Pharmacy/Pharmacist
Director/Manager of Medical Informatics Chief/VP of Nursing Services/Asst Director/Case Manager
Director/Manager of Telecommunications/Call Center Director/Manager Other Title (please specify)
  What is the number of employees in your entire organization? (select only one)
less than 50 1,000 - 4,999
50 - 450 5,000 - 9,999
451 - 750 10,000 - 19,999
751 - 999 20,000+



 
Security Check: Enter both words below, separated by a space.

     

* Note that a valid email address is required to fulfill your request. Please verify that the email and mailing address you provided are accurate before hitting the submit button.
* The publisher reserves the right to limit the number of free subscriptions and/or reject requests based on information provided.


Problems with the form? Webmaster@TradePub.com
Copyright © 2008 NetLine Corporation, All Rights Reserved.
Copyright © 2008 Eyecare Business, All Rights Reserved.