Healthcare Purchasing News Free Subscription

	*Healthcare Purchasing News* is free to qualified professionals. Summary Description
	To apply for a FREE subscription to *Healthcare Purchasing News*, 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 Healthcare Purchasing News?*

Yes No

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

Yes, I would like to receive Healthcare Purchasing News' daily email newsletter.

Yes, send me special offers, contests, etc, via email.

(Please note that Healthcare Purchasing News will NOT release your email address to any other company or individual.)

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.	The name of the high school you graduated from: (This question is asked only as a replacement for your signature to verify the subscription for auditing purposes)

3.	Are you a member of a product evaluation committee?

Yes No

4.	Please indicate type of Facility/Service/Firm: (select only one)

Stand Alone Hospital (for-profit, non-profit, government) Home Health Care

Integrated Network (multiple hospitals and alternate sites) HMO/PPO

Hospital Group Purchasing Organization or Alliance Insurance/Accounting/Investment/3rd Party Administrator

Multi-Hospital System Corporate Headquarters Distributor

Government Purchasing Agencies Manufacturer

Surgi-Center/Ambulatory Care Center Other (please specify)

Long-Term Care

5.	Please select the category that best describes your job title: (select only one)

VP/Director/Manager of Material CEO, CFO, COO

Asst Material Mgr/Other Material Mgmt Personnel Head Nurse/Director of Nursing

Chief Purchasing Director/Purchasing Manager Medical Director

Buyer/Purchasing Agent/Other Purchasing Personnel Nursing/Practitioner

Central Service Director/Supervisor/Manager Consultant

Other Central Service Personnel (Tech, Coord) Value Analysis Coordinator

Infection Control Practitioners/Director/Supervisor Professional Department Head

OR Director/Manager/Supervisor Evaluation/Standardization & Safety Committee Member

Surgical Services Director/Manager/Supervisor Contracts Director/Manager/Supervisor

OR Material Manager Clinical Educator

Other OR Personnel involved in Purchasing Other (please specify)

VP Support Services

Hospital Administrator

6.	Number of beds in your organization? (select only one)

500+ 100-199

400-499 50-99

300-399 26-49

200-299 0-25

7.	Please check the area for which you have purchasing involvement: (select only one)

Operating Room Products & Equipment Central Service Products & Equipment

Infection Control Products & Equipment Monitoring & Diagnostic Equipment

Business Equipment & Supplies

8.	Which of the following products/services do you recommend, specify, or buy? (select all that apply)

INVENTORY CONTROL OPERATING ROOM cont.

Asset Management Products/Services Gowns and Protective Wear

Bar Coding/RFID, RTLS & Labeling Systems Instruments

Cabinets Orthopedics

Carts Scheduling Systems

Computer Hardware Surgical Gloves

Contract Management Systems Surgical Lights, Lighting Systems

File & Retrieval Systems Tables and Stretchers

Forms Wound Care/Hypothermia Products

Handheld/Point-of-Use Products Other OR Products

Instrument Tracking Systems INFECTION CONTROL

Materials Management/Supply Chain Info Systems incl. ERP modules Air Purification Systems

Printers/Scanners/Copiers/Multi-function Cleaning Equipment & Supplies

Storage Systems Disaster Preparedness Products

Other Inventory Control Products Disinfectants & Sterilants

PATIENT CARE E†O Monitoring Devices

Bariatric Specialty Equipment/Supplies Gloves

Diagnostic Equipment Hand Hygiene Products & Dispensers

ID/Security/Alert Systems Protective Wear

IV Systems/Syringes Sharps Safety Products

Linen Sterilization Supplies & Equipment

Patient Beds/Furniture Sterilization Wraps & Containers

Patient Transport/Lift Products Other Infection Control Products

Patient Warming/Positioning Products OTHER PURCHASING & SERVICES

Respiratory Care & Monitoring Business Equipment & Supplies

Scales Communications Equipment

Temperature/Blood Pressure Monitors Environmental Services Products

Wound Management/Bandages/Wraps Facility Equipment & Maintenance

Other Patient Care Products Equipment Food & Dietary Supplements

OPERATING ROOM Food Service Equipment

Cardiac Equipment and Supplies Imaging Supplies & Equipment

Catheters/Needles Laundry Supplies & Equipment

Critical Care Shipping and Transportation

Custom Procedure Trays/Kits/Packs Waste Management

Drapes None of the Above

Endoscopy/Endoscopic Products

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* The publisher reserves the right to limit the number of free subscriptions and/or reject requests based on information provided.