1 Select one that best describes you:
Independent Practicing Physician
Practicing Physician in a Group/Partnership
Practicing Physician in an HMO
Practicing Physician in a Hospital
Practicing Physician in a Teaching Hospital
Researcher
Midwife
Certified Nurse Midwife
Nurse Practitioner
Nurse
Physician Assistant
Sonographer Technician
Resident
Student
Consultant
Medical Service
Medical Products Vendor
Other Medical
Other Vendor
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2 Number of years in Practice/Business:
1-5
6-10
11-15
16-24
25+
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3 City
4 State or Province
5 Country
6 Your age:
under 25
25 - 35
35 - 45
45 - 55
55 - 65
over 65
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7 Your sex:
8 How useful to you is the information on OBGYN.net?
Very Useful
Useful
Not Very Useful
No value at all
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9 How easy is it to locate information on OBGYN.net?
Intuitive
Easy
Average
Difficult
Impossible
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10 Are you interested in placing information about your practice or organization on-line?
11 How long have you been using OBGYN.net?
New User (<3 months)
3 to 6 Months
6 Months to 1 Year
1 Year to 2 Years
More Than 2 Years
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12 How often do you visit OBGYN.net?
daily
several times a week
weekly
monthly
only occasionally
first visit
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13 How often do you buy products online?
daily
several times a week
weekly
monthly
only occasionally
never
do not now, but if it was easy and made sense I would
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14 What information is most important to you?
15 What other topics would you like to see added?
16 Will you use OBGYN.net again?
17 I've made OBGYN.net one of my favorite bookmarks or home page:
18 How did you find OBGYN.net?
search engine
link from other site
direct mail
colleague
patient
print media
Internet demonstration
conference or cybercafe
mailing list
other
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19 Any additional comments?
Contact Information
21 May we contact you later for a follow up survey?
22 Your Email Address:
23 Phone Number:
24 Fax Number:
25 Your Full Name:
26 Title:
27 Organization:
28 Address Line 1:
29 Address Line 2:
30 Zip or Postal Code:
31 Hospital Affiliations:
32 Physician Number (DEA in USA, or equivalent):
33 Association Memberships:
34 Would you be willing to participate in OBGYN.net by:
Becoming an Editorial Advisor
Submitting an article
Participating in an "Ask The Experts"
Volunteering for one day a month on the Women's Health Forum
Doing an interview
Can volunteer for multiple activities and/or specialties
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35 What specialty area are you interested in providing information about?
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