Health Facilities Management
  Health Facilities Management is free to qualified professionals. Summary Description
  To apply for a FREE subscription to Health Facilities Management, 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


 
1. Do you wish to receive a FREE subscription to Health Facilities Management?
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)
Address:
Department/Mail Stop:
City:
State:
Zip Code/Postal Code:
Country:
(Note: If your country is not listed above, subscriptions are not currently available at your location.)
Company Phone:
Company Fax:
Email Address:
(Note: Valid email address is required or you could be disqualified.)
 
Yes, please auto-fill my contact information for other publication qualification forms.

Hospital/Nursing Home Personnel (bed count): # of Beds (Enter 'N' if unknown)

  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)
From time to time HFM and its partners may use the information provided to offer you pertinent industry information.


2. Please check the one category which best describes your title/business: (select only one)
Hospital/Nursing Home Personnel: Hospital/Nursing Home Personnel: cont.
VP/Asst Adm Facilities Mgmt. Nursing Home Admin
VP/Asst Adm Plant Oper/Bldgs/Grds Biomedical/Clinical Engr
VP/Asst Adm Support Svcs Multi-Hospital System Personal:
Dir/Asst Dir Engineering Facility Mgr/Bldgs/Mtce/etc.
Dir/Asst Dir Facilities Mgmt Construction Manager
Dir/Asst Dir Plant Oper/Bldgs In-House Architect
Dir/Asst Dir Support Services Other Health Care Organization Personnel:
Dir/Asst Dir/Chief of Maintenance Medical Clinic/Group Practice
Dir/Asst Dir Env Svcs/Hskpg Surgi/Emerg/Ambul Ctr
Dir/Asst Dir Safety/Security Architectural Firm
Dir Planning/Development Consultant Firm
Matls Mgr/Chief Purch Ofcr Building Contractor
Infection Control Officer Govt/Vol Health Org
Construction Manager Group Purchasing Org
Laundry Manager Interior Designer
In-House Architect Landscaping Professional
Dir/Asst Dir Telecommun Mfg Equip & Svcs
Data Processing Manager Other (please specify)


3. From time to time Health Forum and its partners may use the information provided on your subscription/renewal to offer you pertinent industry information. Do you wish to receive this information?
Yes     No


4. HFM is an audited circulation magazine. In order to verify request without availability of a signature, Health Forum's auditors require that we ask for one piece of personal information from you. This information is solely for the purpose of audit requirements. What is the city of your birth?


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  Which of the following best describes your industry? (select only one)
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  What is the number of employees in your entire organization? (select only one)
1-99 1,000-4,999
100-999 5,000+
  Do you currently have a budget defined for your project?
Yes     No

If Yes, are you the budget owner?

Yes     No
  How many months have you been researching potential solutions? (select only one)
0-3 months 6-9 months
3-6 months 9-12 months
  What is your timeframe for making a purchasing decision? (select only one)
90 days or less 181 days to 270 days
91 to 180 days 271 days to 360 days

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Copyright © 2008 Health Facilities Management, All Rights Reserved.